Variances from biopsy & mastectomy pathology reports

Options
RedemptiveSufferer
RedemptiveSufferer Member Posts: 242
edited September 2017 in Diagnosed and Waiting for Test Results

Waiting for pathology report following mastectomy. Was anyone surprised at their results based on their original biopsy? Different cancer? Additional cancer? Tumor size way off? Hormone receptors were different? etc... Would think the last one wouldn't change, but I don't know. Thank you!!

· Share on FacebookShare on Twitter

Comments

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

    Yes, my biopsy said ILC on both tumors. After mastectomy pathology said one was IDC. The Nottingham scores were slightly different before both were 6 after mastectomy it was 6 and 5. Same exact er positive 95% pr less than 1%. I only got 1 oncodx score so maybe they just sent one tumor sample.

    · Share on FacebookShare on Twitter
  • RedemptiveSufferer
    RedemptiveSufferer Member Posts: 242
    edited December 2016

    Meow13, so they didn't say what the other tumor was? That would have me curious...this entire journey does.

    · Share on FacebookShare on Twitter
  • Momy4ever
    Momy4ever Member Posts: 30
    edited February 2017

    i had a change in hormone receptors, according to the biopsy result I was er+ 25% . In path report after surgery triple negative. I don't know if I shall still take hormone therapy based on the biopsy or no. My mo doesn't agree but another mo I consulted for second opinion thinks I should have hormonal therapy. Very conf

    · Share on FacebookShare on Twitter
  • Wildplaces
    Wildplaces Member Posts: 864
    edited February 2017

    One of the many reasons breast cancer is tricky to treat and responds differently in different people is that the tumour mass can be quite heterogenous histologically.


    So I believe the answer is yes to all of your questions.
    My understanding is that biopsy is not used to characterise the tumour ( although some of that info is reported) it lets you know that you have a positive non benign mass and may together with size guide your surgical decision.


    Biopsy will not give you an answer to tumour size or the present of additional 'spots' - imaging will to some extent (ultrasound may underestimate a lesion, MRI is usually close to size, both PET/CT and MRI may miss a small ( less then 0.5 cm) area that is maybe DCIS and not active.


    Pathologist will talk about " shuffling of grades" between biopsy and main specimen - it is usually by one or two points only.
    The hormone receptors have different methodology depending on the lab - but yes they should be reasonable consistent between the two.


    · Share on FacebookShare on Twitter
  • Wildplaces
    Wildplaces Member Posts: 864
    edited February 2017

    Momy4ever,


    It is SUPER important to know if antihormonal said are an option for you.


    Particularly if you are in the group that tolerates them well.


    I would personally urge you to seek a second pathology opinion - ask the lab to send both sets of your slides to another pathologist - and before you do find one that is very GOOD in your area.


    This is done all the time - particularly in complex lesions.


    It might involve an additional cost but I feel might be well worth it.

    I think of it (and I am not a specialist in the area - it is from what I have read) that it is a beast with spots - that no tumour is all grade 3 (there are areas of grade 1 or 2 in it) and vice versa a grade 1 may have grade 3 cells in it... and it may be the same with receptors - hence the difference.
    (I find it very annoying and stressful to "fight" for the best possible treatment, make me feel always like I am asking for something.... but that is what we must try and do.)

    · Share on FacebookShare on Twitter
  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited February 2017

    My tumor was about the size predicted by my MRI and US. However, the grade changed from 2 to 3 and the tumor went from ER+PR+ to PR -, considered a more aggressive cancer. . As a result my treatment changed from lumpectomy plus rads to lumpectomy plus chemo. Then genetic testing revealed 2 gene mutations that cause BC and the breasts had to go, too.

    · Share on FacebookShare on Twitter
  • windingshores
    windingshores Member Posts: 704
    edited February 2017

    My biopsy was HER2+ and my post surgical results were HER2-.

    My second opinion told me she was best buddies with my first opinion, so I felt I needed another one.

    By the time I was satisfied, four different labs had done my pathology, a second Oncotype had been done (long story) and I had seen 4 different oncologists total!  But I felt at ease and trusted the results I ended up with. No regrets.



    · Share on FacebookShare on Twitter
  • momand2kids
    momand2kids Member Posts: 1,508
    edited February 2017

    Yup

    biopsy said the size was about 1.2 turned out to be 2.5. I was ER+/PR+ HER- on pathology-- Oncotype had me at PR-

    Onc said surgical pathology trumps all else.....

    · Share on FacebookShare on Twitter
  • windingshores
    windingshores Member Posts: 704
    edited February 2017

    I don't know, MD's seem to say Oncotype trumps all else.

    My post surgery pathology was grade 3 with high ki67% and LVI but Oncotype was only 8 (ER+, PR+).  It was unsettling to have the pathology results and Oncotype tell such different stories.  I guess I could end up in the margin of error in the stats!

    · Share on FacebookShare on Twitter
  • Sam2U
    Sam2U Member Posts: 233
    edited February 2017

    Was anyone surprised at their results based on their original biopsy? Yes

    Different cancer? Yes Biopsy 1 showed IDC/DCIS, Biopsy 2 showed IMC

    Additional cancer? No Doctors originally said I was multifocal with two different types, pathology said no.

    Tumor size way off? Yes, I was told it was "small" like 2 MM, 1 CM in the other spot, it was one large 9.5 CM tumor

    Hormone receptors were different? Not really, percentages a little different Her 2 was different but in the degree of negativity

    However, I chalk up my differences to the hospital/lab--it was not a teaching hospital or a pathologist that specializes in breast cancer. When my treatment hospital reviewed all MRI's, slides, etc. after surgery they came to different conclusions than the hospitals/labs from Biopsy 1 and 2. They also gave me a lengthy report supporting their conclusions.



    · Share on FacebookShare on Twitter
  • Shellsatthebeach
    Shellsatthebeach Member Posts: 316
    edited September 2017

    Yes, last Fri. I found out my pathology report from my biopsy was different than my surgery biopsy. As if my biopsy report wasn't bad enough as a stage IIIb, my tumor was upgraded from a 2 to a 3 and my Her2 negative status changed to Her2 positive.

    · Share on FacebookShare on Twitter

Categories