help understanding my pathology report

twistygirl

I had my lumpectomy on Wednesday and due to the new rules about testing results, I received my pathology report last night. Can someone help me understand it a bit more? I understand most of it - no node involvement, no lymphatic invasion, clear margins (tho one margin is only 1mm... is that ok?) But it also says atypical lobular hyperplasia and that fibroadenomatous hyperplasia. I have very dense breasts and had a fibroadenoma biopsied in the left breast at the same time as the right breast cancer was found. I just want to be sure I understand exactly what's going on with these breasts of mine and what to do. I have my post-op appointment next FRIDAY. So it's a long week ahead until I can actually ask a doctor what all this means and what my next steps will be. My question is - is my right breast more at risk for recurrence because of the lobular hyperplasia, in addition to the IDC. And should I be concerned about the fibroadenoma in my LEFT breast because maybe the right cancer was a fibroadenoma that turned cancerous! Thank you!

Final Diagnosis:
1. RIGHT AXILLARY SENTINEL LYMPH NODES, EXCISION:
- THREE LYMPH NODES NEGATIVE FOR METASTATIC CARCINOMA (0/3).

2. RIGHT BREAST, LUMPECTOMY:
- INVASIVE DUCTAL CARCINOMA, NOTTINGHAM GRADE 1, 9.5 MM.
- SURGICAL RESECTION MARGINS ARE NEGATIVE FOR CARCINOMA.
- PREVIOUS BIOPSY SITE CHANGES.
- FOCAL ATYPICAL LOBULAR HYPERPLASIA.
- FOCAL FIBROADENOMATOUS HYPERPLASIA.

Specimen Identification:
Procedure: Excision (less than total mastectomy)
Specimen Laterality: Right
Tumor Size: Greatest dimension of largest invasive focus >1 mm (specify exact
measurement) (millimeters): 9.5 mm
Histologic Type: Invasive carcinoma of no special type (ductal)

Histologic Grade (Nottingham Histologic Score):
Glandular (Acinar)/Tubular Differentiation: Score 1 (>75% of tumor area forming
glandular/tubular structures)
Nuclear Pleomorphism: Score 2 (cells larger than normal with open vesicular
nuclei, visible nucleoli, and moderate variability in both size and shape)
Mitotic Rate: Score 1 (less than or equal to 3 mitoses per mm2)
Overall Grade: Grade 1 (scores of 3, 4, or 5)

Ductal Carcinoma In Situ (DCIS): Not identified

Margins:
Invasive Carcinoma Margins: Uninvolved by invasive carcinoma
Distance from closest margin (mi
llimeters):
Less than 1 mm
Specify closest margin: 12 o'clock

DCIS Margins: Not applicable (no DCIS in specimen)

Regional Lymph Nodes: Uninvolved by tumor cells
Number of Lymph Nodes Examined: 3
Number of Sentinel Nodes Examined: 3
Number of nodes with metastatic carcinoma/ total number of nodes
examined: 0/3

Treatment Effect:
Treatment Effect in the Breast: No known presurgical therapy
Treatment Effect in the Lymph Nodes: Not applicable

Lymphovascular Invasion: Not identified

Pathologic Stage Classification (pTNM, AJCC 8th Edition)
Primary Tumor (Invasive Carcinoma) (pT):
pT1: Tumor 20 mm or less in greatest dimension
pT1b: Tumor >5 mm but 10 mm or less in greatest dimension
Regional Lymph Nodes (pN):
Modifier - (sn): Sentinel node(s) evaluated. If 6 or more nodes (sentinel or
nonsentinel) are removed, this modifier should not be used.
Category (pN): pN0: No regional lymph node metastasis id
entified or ITCs
only

TISSUE SENT FOR HORMONE RECEPTORS, Ki-67, AND HER2/NEU: No, please see previous
biopsy results

Tumor blocks best suited for ancillary study: 2C-2E

The lesion is categorized as pT1b N0 (sn).