Understanding Pathology Report

Question: Understanding my report:
invasive ductal carcinoma
-histologic grade: nottingham histologic score III/III (tubule score=3, nuclear score=3, mitoses=2)
-size of largest focus: 09 cm
Estrogen receptor-negative (0%)
Progesterone receptor-negative (0%)
HER2/neu-positive (3%)

Answer: Thank you for contacting us. I think I need a little more information from the report before offering advice. It says largest focus 09 cm. Was that 0.9 cm? or 9 cm? I’m assuming they meant 0.9 cm so then was this a core biopsy or a lumpectomy? I don’t see mention of surgical margins so I’m thinking this was a core biopsy. The fact that this is a high grade tumor that is ER/PR negative and HER2 positive (the ki-67 % didn’t come through in the email) means you are likely to require chemotherapy, either in a neoadjuvant or adjuvant setting depending on whether this was a core biopsy or a surgical biopsy. Right now, I would need more information before I could comment on the stage of your cancer and what would be recommended in terms of treatment. If this was just a core biopsy you will need to undergo a sentinel node biopsy since the diagnosis is invasive cancer. I would recommend going to a multi-disciplinary cancer center if there is one near you, where the breast radiologist, surgeon, medical oncologist, radiation oncologist, and pathologist can discuss your exams and your overall case together to come up with the best treatment option for you. Best wishes to you and I hope it’s just a 0.9 cm tumor and your axillary nodes are negative.

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