Newly diagnosed - path report

Hi ouray17,

We're so sorry to hear of your diagnosis, but thankfully you found our Community, the best place to get answers, support, and advice.

We're sure others will be popping in shortly to help explain these pieces of your path report and offer their help. In the meantime, you may want to check out the main Breastcancer.org site's section on Your Diagnosis, which explains what each piece of your path report means. There's also helpful information about treatments, questions to ask, further testing, and much, much more on the Breast Cancer 101 page.

We hope this helps and we look forward to hearing more from you soon!

--The Mods

Fat cells and adrenal glands make androgens. The liver makes a hormone called aromatase that is a catalyst for converting the androgens into estrogens. The class of drugs called aromatase inhibitors,aka AIs (anastrazole/Arimidex, letrozole/Femara, exemestane/Aromasin) short-circuits this process by interfering with aromatase’s actions.

Being 60, with the tumor so highly ER+, PR+, and HER2-, coupled with the tumor being <1cm and only Grade 1, it’s highly unlikely that an OncotypeDX test would even be ordered—but if it were, you’d probably be well within the “low risk” area. Is this a biopsy path result, or after surgery? If after surgery, you get the same results, the margins surrounding the tumor are clear and no lymph nodes are positive, you would first be advised to get radiation (and at >60, perhaps the shorter partial-breast protocol I had) and then some anti-estrogen drug—usually an AI but perhaps Tamoxifen.

Did you have surgery and if so, was it lumpectomy or mastectomy?

Ouray - it is important to note that the ER+ aspect of the pathology report does not correspond to how much estrogen you are making, but rather it is a measurement of how many estrogen receptors are present on the breast cancer cells. If you receive a percentage number - say 70% ER+, that means that out of 100 cells looked at on the slide by the pathologist 70 of them had estrogen receptors, thus the percentage number. Having had a hysterectomy, and age or menopausal status, do not necessarily have any bearing on how many receptors may be present. As has been pointed out in the posts above, your body continues making estrogen in other ways after a hysterectomy or menopause, and that estrogen feeds the receptors on the cells. For this reason, even though you have had a hysterectomy, you will need anti-hormonal medication post surgery, regardless of what type. I am also 60, and had a total hyst/ooph at 45 due to numerous fibroids. My ER+ percentage was 96%, quite high, so I have been on anti-hormonals for the past 6 years. Ki67% is a measurement of a protein cast associated with cell proliferation, and is used by physicians to determine tumor aggressiveness. It is considered useful info by some docs and not by others, as some feel it is an unreliable marker. Generally, a Ki67% over 20% is considered high, 10-20% considered borderline, under 10% is low. Hope this is helpful.