Pathology results

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gammaw55
gammaw55 Member Posts: 16
edited September 2016 in DCIS (Ductal Carcinoma In Situ)

--Hi everyone. Posted here earlier before I had my surgery 7-27-16. Went and got copies of my pathology results. Believe my final Dx is DCIS.

Architectural pattern- comedo, solid and cribiform

Nuclear grade 2 intermediate

Necrosis- present central

Margins - Free of neoplasia with nearest margin being anterior skin margin at 2.6 cm.

Lymph nodes - 3 sentinel lymph nodes, negative for metastasis

Pathologic staging pTis (DCIS), pNO (SN), pM not applicable

Additional pathologic findings: extensive sclerosing adenosis and multiple cysts identified.

Ancillary studies: ER Positive (80% of strong intensity)

Note: The area of DCIS is extensive; therefore, two selected slides were selected for immunostains to confirm the presence of myoepithelial cells. These stains were smooth muscle myosin heavy chain and p63, which were both positive confirming the presence of myoepithelial cells in the absence of invasion.

Size of DCIS largest focus upper outer quadrant 3.6cm x 2.7cm x 1.7 cm

From what I am reading and understanding it seems to be a good prognosis, but unsure what the pTis and pNO means. Sorry my post is so long. Have really enjoyed reading these posts and learning so much. Couldnt have done it without you all. Thanks again for all your help. HUGZ











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Comments

  • Meow13
    Meow13 Member Posts: 4,859
    edited September 2016

    sounds good. Good luck to you.

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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    Thank you Meow13

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2016

    Your report is using the TNM staging system. The small letter p stands for surgical pathology rather than biopsy pathology. T = size and/or extent of primary tumor, N = degree of spread to regional lymph nodes, M = presence of distant metastasis. In your case, the Tis means that only "in situ" cancer was found, no invasive component - or pure DCIS, the N for you is 0, meaning no cancer was found in your axillary lymph nodes, and the M for you says not applicable because cancer does not appear to have left the breast or become invasive as evidenced by the pathologic finding of pure DCIS. All good things! Here is a link that further elaborates the TNM staging system:

    https://en.wikipedia.org/wiki/TNM_staging_system

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  • LAstar
    LAstar Member Posts: 1,574
    edited September 2016

    Wonderful margins!

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited September 2016

    Hi gammaw55:

    Have you had an appointment with your surgeon after the surgical pathology was made available, or do you have one scheduled? The surgeon should meet with you to convey your definitive diagnosis in light of all available pathology and test results, among other information (e.g., recommended follow-up).

    This summary of the 7th edition of the AJCC staging manual is quite helpful:

    https://cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf

    Re your result, with reference to the above:

    Pathologic staging ("p" for pathologic): pTis (DCIS), pN0 (SN), pM not applicable

    "Tis (DCIS)" = Ductal carcinoma in situ (see page 1, left column, near top under "Primary Tumor")

    "N0 (sn)" = No regional lymph node metastasis identified histologically, as determined by sentinel node biopsy (see page 2, upper right)

    "Classification based solely on sentinel lymph node biopsy without subsequent axillary lymph node dissection is designated (sn) for "sentinel node," for example, pN0(sn)." (see page 2, right column, notes at bottom re "(sn").

    If the pathology reports from all your biopsies also showed pure DCIS (with no evidence of invasion), then my belief would be the same as yours (Stage 0, DCIS).

    BarredOwl

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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    Thank you so much SpecialK for the info and link. HUGZ

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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    Thank you Barred Owl for the info. Have been back to see him but before I got the path report. He just said e thing was ok and return in 3 months or before if needed.

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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    Thank you Meow13

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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    HUGZ LAstar

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited September 2016

    Hi gammaw55:

    Please contact hime to request that he review your pathology reports from biopsy and surgery, and advise you by phone regarding the final diagnosis and stage. Also ask him to expressly confirm that in light of all relevant information, no further consultation with a radiation or medical oncologist would be recommended in your case.

    We are laypeople with no medical training, so the best practice is to obtain timely and active review and consideration of your pathology reports and the expert advice of your surgeon regarding the above.

    Best,

    BarredOwl


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  • gammaw55
    gammaw55 Member Posts: 16
    edited September 2016

    BarredOwl, thanks for your response. At my last follow up visit with him he asked me if I had seen the MO again after surgery, which I had, with no further tx needed.

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