Post surgery pathology

KathyL624 · December 2016

Is the post surgery path report a report of the total picture? For instance, my tumor was 8mm measured by ultrasound at my local hospital. Had surgery at MSK and the post surgery report said 8 mm tumor so was that the total picture?

Also the report from MSK said my Nottingham score was 4 but my biopsy report said it was 5...and biopsy said moderate ER staining (99%) receptive but post surgery report said strong staining (99%) receptive. What reportdo i Believe?

Goincrzy8 · December 2016

I trust the path after surgery, they have the tissues etc taken from the breast. The orig biopsy IMO tells us we have Breast Cancer, it does not say you have x amount of neg or positive nodes. That node involvement determines future therapy. My orig biopsy had me as lumpectomy, radiation and hormone therapy. Ended up UMX with 12 positive nodes, so now chemo is in my future. NOT what I wanted, but what I need to do.

keepthefaith · December 2016

kathy, you should probably consult your MO, but I believe they base your treatment plan on your surgical pathology. The biopsy is not going to have any information about your lymph node status or LVI and sometimes the diagnostic imaging is not always accurate in determining the actual size. My biopsy said I was grade 3 and my surgical path report said grade 2. Maybe a difference in the Dr's that read it...IDK, regardless, I did chemo and don't think it changed my treatment plan at all. They may want to do more testing, such as onco-type and BRCA before they determine your treatment plan. There are a lot of pieces to the puzzle! Best wishes.

Michelle_in_cornland · December 2016

There is no Nottingham 4 or 5, it just goes up to 3. Must have been something to do with scoring the Nottingham by points. Each group gets a grade, a number 5 would be put you at the high end of grade one....going into grade 2.

MinusTwo · December 2016

It's my understanding that the biopsy reports from surgery are more accurate since they take wider samples.

KathyL624 · December 2016

I should add that surgery was in March. Both biopsy and surgery pathology called me grade 1 with an 8mm tumor. The difference was my post surgery path said my tubule score was 1 and biops called it 2. So still Grade 1 but a difference of a 4 or a 5. Also surgical path said ER staining was strong but the biopsy report said moderate.

My surgical report also said no discrete tumor was found, they think most of it came out at biopsy. So do you think the Sloane pathologists interpreted things slightly differently?

Post surgery pathology

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