Understanding Pathology Reports

Question: i had a needle core biopsy and this is what the pathology said but i do not understand
right breast
-invasive mammary carcinoma
-no lymphovascular or ductal carcinoma in situ identified
–breast cancer prognosis profile
–estrogen recptor 100% positivity(favorable)
–progesterone rector 100% positivity(favorable)
–ki-67-30% postivity(elevated, unfavorable)
–her2 cen-17 ratio pending
can you help me understand it

Answer: Invasive mammary carcinoma is basically a term used to describe the most common type of breast cancer that doesn’t fall into one of the “special types” categories. It represents approximately 65-75% of breast cancers depending on the study although many feel this % is higher. Many pathologists use the term invasive ductal carcinoma for this diagnosis although I favor using invasive mammary carcinoma as your pathologist did. The fact that there was no lymphovascular invasion is good, as is the fact that your cancer is very strongly positive for estrogen and progesterone receptors which are favorable prognostic indicators. The ki-67 being at 30% is a little on the high end. That means the tumor is proliferating somewhat fast. While that doesn’t necessarily sound great, chemotherapy targets rapidly growing cells so it’s kind of a double-edged sword. That may mean your cancer will respond better to chemotherapy. I can’t comment on the her2/neu stain as you said it was pending. Also, did they give a Nottingham grade to the cancer? In your pathology report it would be listed as grade I, II, or III (scores ranging from 3-9).  At this point, since you had a needle core biopsy with invasive cancer, you will need further surgery and a sentinel node biopsy. After you get the results of those tests, I could give you a little more information about what to do next

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