Not all breast cancers are the same. A biopsy is needed in order to diagnose breast cancer. Once biopsied, cells are sent to a lab for a pathology report. The following information will usually be available on this report if the cells studied are cancerous:
- Diagnosis: This is the most important part of the pathology report. It gives the final diagnosis and may include information on the cancer such as tumor size, type, grade, hormone receptor status and HER2/neu status.
- Tumor Size: Tumor size is most often reported in centimeters or millimeters. The best way to measure tumor size is under a microscope. In general, the smaller the tumor size, the better the prognosis.
- Non Invasive vs. Invasive:
- Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer (stage 0).
- Invasive breast cancer (also called infiltrating cancer) means the cancer cells inside of a milk duct or lobule have broken out and spread to nearby tissues.
- Tumor Grade: For invasive breast cancers, the shape is noted and a grade is assigned. Tumor grade relates to the structure of the cells. It is different from tumor stage. This determines how different the cancer cells look from healthy cells. In general, the more the cancer cells look like normal breast cells, the lower the grade and the better the prognosis.
– Grade 1: Cells look most similar to normal and are not growing rapidly.
– Grade 2: Cells look somewhat different than normal.
– Grade 3: Cells look very abnormal and may be spreading/growing rapidly.
- Tumor Margins: During a surgical biopsy, an area of normal breast tissue around the suspicious area will be taken out to be sure the entire tumor is removed. The pathologist looks at the margins and decides whether or not they contain cancer cells.
– Positive (involved) margins: Contain cancer cells.
– Close margins: Cancer Cells approach but do not touch the edge of the biopsy.
– Negative (not involved, clear or clean) margins: Do not contain cancer cells
- Lymph Node Status: If lymph nodes were removed, a pathology report will show if the lymph nodes contain cancer cells.
- Hormone Receptor Status: Hormone receptors are proteins found inside some cancer cells. When hormones (estrogen and progesterone) attach to these receptors, they make cancer cells grow. Knowing the hormone receptor status will help guide your treatment.
– Estrogen and Progesterone Receptive-positive (ER+ and PR+) tumors have many hormone receptors and treatments that prevent the cancer cells from getting the hormones they need to grow may stop tumor growth. .
– Estrogen and Progesterone Receptive-negative (ER- and PR-) tumors have few or no hormone receptors and are not treated with hormone therapies.
- HER2/neu Status: (human epidermal growth factor receptor 2) is a protein that occurs on the surface of some breast cancer cells.
– HER2/neu-positive (HER2+) tumors have many HER2/neu genes inside the cancer cells (also called HER2/neu over-expression), which causes a large amount of HER2/neu protein on the surface of the cancer cells. About 15-20 percent of breast cancers are Her2+. These breast cancers tend to be more aggressive than other tumors.
– HER2/neu-negative (HER2-) tumors have few HER2/neu genes inside the cancer cells and little or no HER2/neu protein on the surface of the cancer cells
- Triple Negative: If all three statuses are negative (ER, PR, and HER2/Neu) then the patient’s cancer is Triple Negative Breast Cancer. The current standard of treatment for these cancers is some combination of surgery, radiation therapy and chemotherapy. These cancers tend to be very aggressive and recur early.
Learn more about breast biopsies: http://ww5.komen.org/BreastCancer/Biopsies.html
Learn more about types of breast cancer tumors:
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