Quick Pathology Question

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EastcoastTS
EastcoastTS Member Posts: 864

I got my final pathology about a week after surgery (surgery 4 weeks ago). There was nothing about my ER/PR/HER2 status there. I do have this from the biopsy path of course. Which was run initially, then run again at 2nd opinion hospital. Same results.

So -- don't they run that again with the surgical sample? That seems odd to me. The MO said no if they get clear from biopsy sample. I also read it comes with the Oncotype, which I received yesterday (via phone call -- I only got my #: 14. Nothing else until I see the actual report.)

THANKS for advice!!!

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  • MTwoman
    MTwoman Member Posts: 2,704
    edited March 2017

    EastcoastTS, I had the same impression as you did, and did get pathology from my mx surgery. I'm not sure why they wouldn't want to make sure that the cells that they took during the biopsy had the same characteristics as those they removed during the surgery. BC tumors can be heterogeneous and I've read women's posts from these forums where their pathology was different from different samples - and the final pathology report must take them all into consideration. Just curious, did your Oncotype come from the original biopsy sample or the surgical sample? And if it came from the surgical sample, why wouldn't they re-run the ER/PR/Her2? Maybe someone else here can shed some light on this, I am stumped.

  • Lisey
    Lisey Member Posts: 1,053
    edited March 2017

    they didn't run mine again, but the oncotype does, so you'll get those results from the tumor itself.

  • SpecialK
    SpecialK Member Posts: 16,486
    edited March 2017

    Often they don't re-run path if it doesn't change treatment parameters, or if something like OncotypeDx done on the post-surgical sample will re-confirm the biopsy findings. I had biopsy path, then had Mammaprint on a biopsy sample, did not have post-surgical receptors and Her2 run again post-surgically because it would not have changed my treatment going forward - I was bound for chemo/Herceptin/anti-hormonals regardless because even if other areas of the tumor showed differing characteristics the biopsy sample clearly showed ER+ and Her2+ so treatment decisions were based off of those. My understanding is that Oncotype Dx, almost always done on a surgically removed tissue due to the size needed for testing, takes a fairly large sample and grinds the specimen so you are getting a larger tissue sample size with that test than you would with a pathology slide, and it would either confirm, or be discordant with, the receptor/Her2 biopsy status already identified from the biopsy.

  • EastcoastTS
    EastcoastTS Member Posts: 864
    edited March 2017

    Mtwoman: They ran the Oncotype on the surgical sample, and all I got was phone call with brief discussion (since my MO is in another state) about the #. I didn't think to ask about ER/PR/HER2 during that call. I just could not find it on the final path report. So I was stumped, too. She's sending me the report, so I guess it'll be there.

    Thanks, Lisey and SpecialK. Glad that will be included in the Oncotype results. Every time I feel like I know what I need to know about BC, more questions arise!

  • EastcoastTS
    EastcoastTS Member Posts: 864
    edited March 2017

    Also, guys, I never had a Ki-67 reading? I asked and was told it would be done on the surgical sample, but again, not included on the final path report. Will this also be a part of the Oncotype? As you can tell, I love all the info I can get.

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