I'm confused what results mean

So sorry to read you are joining the club. These forums are busy and posts get lost easily, so hopefully this will move you closer to the top again.

Like yours, my BC was diagnosed w a stereoscopic biopsy. "Well differentiated invasive carcinoma, no specific type" does mean you have breast cancer and will need to have surgery, what kind is one thing you will need to decide in the future. Your pathology report seems to be missing some information your will need, like receptor status. My initial pathology report was the same, missing lots of information. Various information was forwarded to me as the rest of the tests results came in and you'll almost certainly be getting more information in the days to come about what else was found in your pathology report and well as information about various treatment options based on your specific situation. Hopefully others will have more to add to this and reading on here will help you become better informed. There is a lot to learn.

Sometimes you don't really get the full picture until after the results of lumpectomy or mastectomy with or without sentinel node sampling.

In the end they have to know the grade (how aggressive) and the size of the tumour and whether it has its own blood supply (lymphovascular invasion), and also whether there is cancer in any of the nearby lymph nodes, how many and how much. This will help determine if you need chemo, and what sort.

Then there are tests to determine the receptors your tumour may or may not have (Estrogen/Progesterone/HER_2), which will determine if any of the targetted therapies might be indicated.

After surgery, depending on the pathology, there may be more tests/scans to establish the extent of the disease if they are unsure.

It really can be a slow and painful process at the start, but once you and the doctors know what you are dealing with, a plan of action will be drawn up, and things get somewhat under control.

Keep calm and carry on!

Depending on the type of cancerous mutation they find, if you need chemo (aggressive type or reason to worry about spread) or targeted drugs (for HER2-positive disease) you can opt to start with chemo and then have a smaller surgery when you are done. This gives you the benefit of potentially reducing the tumor and reducing the scale of the surgery -- plus you get the benefit of knowing which drugs actually work against your cancer cells. When you have surgery first you don't get those benefits.

A great question to ask your doctors is: how much time do I have to decide what I want to do? This gave me more time to prepare my body for chemo but also to get a second opinion.

I hope you start getting a clearer picture of your diagnosis and your options.It is a shock to the get the diagnosis but there are a lot of us gals who have been through the same. People are great here at helping out when they can. Sending big hugs.

Ann

If possible get an Oxycotype test done. My pathology results were similar to yours, ER+/PR+, HER2- (although my tumor was a bit smaller) and I did not need chemo. This test can be very helpful in determining how much chemo may or may not help you personally and is covered by most insurance. From reading these boards, an Oxycotype score seems to be a very good tool / source of info for your doctors and if it hadn't been offered to me, I would definitely have requested it before making any big decisions.

That said, best of luck w the surgeon and I would strongly urge you to get a second opinion. This was very hard for me because I really just wanted to get "it" out ASAP! But I was and still am extremely glad I sought out that all important second opinion. Actually, I interviewed 3 surgeons for the job, but the first one was so lame he doesn't count. Remember, these people work for us! You want to put together the best team you can: a surgeon, oncologist, radiologist and plastic surgeon (if the last 2 if needed)-providers you are comfortable working with and whose abilities and opinions you have faith in.

I'm not sure I understand how that works either. Prior to surgery they thought I had no node involvement, nothing showed on the breast MRI, but as part of my lumpectomy to remove the tumor, sentinel lymph node sampling was also done. Because I'm so lucky, I had 4 sentinel nodes light up and be pulled, along with several aux nodes the surgeon said "just popped out." Anyway, one of my sentinel nodes did contain cancer, making me lymph node positive, but it did not change my treatment plan, other than to make me more likely to go thru w radiation and hormone therapy (both things I've tried really hard to weasel out of). I'm a reluctant patient, at best.

Anyway, I think lymph node involvement (what I have/had) is different than a lymphatic invasion, but I don't know exactly what that means.

Write down all your questions. Take them to your doctor appointments. Make your doctors answer every question in a way you can understand. If they don't, get another doctor. This is my best advice to you. Also, take someone with you to each appt: friend, spouse, sister, whoever, to made sure you hear everything right and to make sure you ask all the questions. Several times my husband was like "Where's your list?" because I needed to be reminded. He also had some good questions for the doctors, some I hadn't thought of myself and corrected me when I seemed to be hearing what I wanted to hear, not what was really being said. Choose someone w a cool head to go with you, because these decisions about treatment choices are not only important, but so very difficult.

I have never really understood LVI. If you don't have it how does cancer get to the lymph nodes? I have LVI and of course my cancer was in one of my lymph nodes. Just curious

Nancy

sunny thanks for explaining that

Do you mind me asking who you used for surgery?  I was just diagnosed Friday.

SheilalLoise, it really depends on where you live. It is important to find a treatment team that you trust and that is local to you. Also, check what your insurance company covers as well.

Lillp07: Sorry I didn't respond sooner. I have had 28 rad tx, and have 5 boosts this week. I started October 27 and will be done Friday. It went faster than I expected, and with few SE so far. Next step for me is to decide if I want hormone therapy. My MO said I don't need it but I am 100% positive for ER and PR. so doing nothing scares me.

sunny - while I agree with your premise to a certain extent, I don't believe the OP in in the U.S.

hi Lillp07 - glad prognosis is good. Just curious what you mean about a small amount of spread and why you have to have all new scans? Hope I am not being nosey - I am also grade 1 so just curious. Good luck with those scans.

Nancy