My mother was just diagnosed.

Lissab, I'm so sorry about your Mother's dx.  Thank goodness you were able to get her to go for a mammogram, and hopefully early detection.  What specifically would you like to know about her pathology report?  Infiltrating is the same as invasive (vs. DCIS).  NOS stands for No Other Specified (meaning it looks like it's pure DCA).  Let us know if any other path terminology needs clarification.   (((Hugs))) to you & your Mother,   Deanna

Lissa: I'm so sorry you have this worry. A couple clarifications: there are 3 things tested for a tumor to determine its phenotype, or which classification it belongs to. Those are Estrogen Receptors (ER), Progesterone Receptors (PR), and whether there is a lot of HER2/neu. The Ki-67 is not a characteristic, but a proliferation index, in other words, it tells the pathologist how quickly the cells are dividing. So, to know more about your mom's diagnosis, you also need to know whether she's considered HER2- or HER2+. Pretty much every woman will have a Ki-67 number. Yes, hers is considered high, but it might mean that chemo is a good option for her. My Ki-67 score was 76 and some women score in the upper 90s. I've even seen a couple 100 results. 

If your tumor was Stage I, then you also had some invasive cancer (IDC) in there as well. If it was nothing but DCIS, then you would be Stage 0. I make the differentiation because knowing your own diagnosis will help frame your mother's and help you to better understand it.

Ask anything you'd like clarification with. There is a lot of knowledge and expertise on these boards. 

Best of luck.

Lissab: I saw that you posted on the Triple Positive forum. If your mom's HER2 status is not yet known, then you can't yet be sure she's Triple Positive. That's the last piece you need to figure out so that you have some idea what course of treatment to expect. Your mom's tumor had a high Ki-67 score, it's not positive for Ki-67. 

From the info you posted above:

• Your mom's tumor is highly dependent on estrogen in order to grow. The 90.19% puts her in the high range. She will definitely be prescribed hormonal therapy. I'm assuming she's post-menopausal, so an Aromitase Inhibitor is most likely. The significant PR score of 49.16% is a good sign. There are several research studies which seem to indicate that a tumor with both a high ER and PR score will respond better to hormonal therapy than one that is ER+ / PR-. 
• The size of 1.3 x 0.05 x 0.02 cm would put it in the Stage I area AS LONG AS there is no lymph node involvement and no distant metastases. 
• A score of 3 for tubule formation means that less than 10% of the tumor had the appearance of a normal breast duct structure. 
• A score of 2 for nuclear pleomorphism means that there was moderate variation in the cellular nuclei of the tumor. Normal, healthy cell nuclei in the breast all resemble each other; however, in a tumor, oftentimes the nuclei of cells vary from one to the next. Your mother's tumor showed a moderate amount of variation.
• A 1 for mitotic count means that there were a fewer amount of cells that were in the active process of division when the pathologist looked at the tissue under the microscope. 
• This puts her at 3+2+1=6. There are 9 total possible points, so a 6 out of 9 puts her at Grade 2. This means Moderately Differentiated cells. The faster a cancer cell divides, the more errors it makes and the less it looks like the normal, healthy cells that surround it. A moderately differentiated designation means that the cells are dividing faster than healthy cells, but not as fast as very aggressive cells. So they moderately resemble normal, healthy breast duct cells. 

I hope this helps you to better understand her pathology report. Again, until you find out whether her HER2 levels were negative, equivocal, or positive, you don't yet know whether she's Triple Positive.

So, you did know that she was HER2+. Well, then with the size of her tumor, she will almost certainly be recommended chemotherapy in conjunction with Herceptin.

Best of luck as you both move through the next phase of her treatment.