Just Diagnosed - Incomplete Pathology Report

luvall - welcome, sorry you have to join this particular club. Question #1 - Yes, it is normal for the hormonal receptor information and Her2 status to take longer than the initial pathology report - the process for these additional tests is more complex and time consuming and in some cases labs send them out if they don't do them in-house. Often these results are on a supplemental or addendum report. Question #2 - The measurement is only of the core itself - which is dependent on where on the tumor it has been taken from, it is not necessarily indicative of the entire tumor size. Different imaging modalities often show somewhat differing tumor sizes, this is very common. The final measurement is the surgical pathology report which looks at the tumor in its entirety if surgery is done first. MRI can be the most accurate imaging for size, and many have one done prior to surgery, or before undertaking neoadjuvent chemo (before surgery), as proper sizing of the tumor is needed before systemic therapy decisions can be made or surgical approach can be discussed, particularly if there have been discordant results with the imaging that has already been done. Also, MRI can sometimes give a more definitive look to check whether anything else is lurking that has previously been unseen in the prior imaging. Question #3 - you need the hormonal receptor and Her2 status before any systemic treatment and surgery decisions can be made. Chemotherapy prior to surgery (neoadjuvent) may be needed if your tumor was triple negative (ER-, PR- and Her2-) or triple positive (ER+, PR+, Her2+), or close to the chest wall or skin and chemo is needed to shrink the tumor to achieve better margins. An informed decision about which order of treatment is best cannot be made without this information. Please don't hesitate to ask additional questions if anything I have said here prompts more inquiry! Here is a link to the page with a booklet you can download about your pathology report from this site:

http://www.breastcancer.org/symptoms/diagnosis/path_checklist

Special K pretty much covered it, but yes, it's normal to wait for those results before deciding anything. You'd think they would rush you off to surgery immediately, but breast cancer isn't like that. My surgeon told me it doesn't travel super fast like that. It's ok to wait to get all the information before making a plan so that you have the best plan and nothing is done in haste.

That said, 2 weeks seems a long time for pathology results to come back. Maybe in a week check in with the office to see if anything is back?!

I had my results, including hormone responsiveness, in 3 days from the local hospital. The HER2 came back as an addendum a few days later. That result was what determined that chemo was needed first.

The size on the pathology report is only the size of the sample that they took. The various imaging that's done often has discrepancies. A lot of people say that MRI tends to "see" more - sometimes even things that aren't there. All of my imaging was pretty consistent, however.

And yes - waiting for the full picture sucks but is vitally important!

Hi SandR! We just wanted to drop a line to welcome you to Breastcancer.org and thank you for your post and tips.

We wish you the best with treatment. If there's anything you need help with or have any comment for us, please feel free to contact us. We're always here!

The Mods