Pathology
Now that I have had my breast biopsy what does the pathology mean?
Benign-a category of breast lesions that do not need to be removed and do not increase a woman’s risk of developing breast cancer. Lesions that fall into this category are fibroadenomas, papillomas, fibrous mastopathy, sclerosing adenosis, PASH (pseudoangiomatous stromal hyperplasia) and various other non-cancerous growths.
Atypical or high risk lesions- (cells dividing faster than normal) A breast lesion that is not cancer, but requires surgical removal as there is an association with breast cancer in a small percentage of these lesions when completely removed. Having one of these lesions increases a woman’s chances of developing breast cancer, and therefore is considered a risk factor. The tissue that is atypical can turn into cancer if it is influenced by certain things such as estrogen. Lesions that fall into this category include, ADH (Atypical Ductal Hyperplasia), LCIS (Lobular Carcinoma Insitu.)FEA (flat epithelial atypia), atypical papillary lesions, radial scars, and phyllodes tumors.
Lobular carcinoma Insitu- LCIS- (Lobular neoplasia) -Cells that are growing faster then normal in the lobules of the breast. This is not cancer although the word carcinoma is in the name. It is more appropriately called lobular neoplasia or lobular newgrowth. It is like atypia, in that, when it is found on a biopsy, it increases the risk of the person developing breast cancer in the future.
Ductal Carcinoma Insitu-(DCIS)- The very earliest stage of breast cancer where the cancer cells are confined to the ducts of the breast. The Grade of the DCIS (how fast the cells divide) is extremely important when determining the treatment. The Van Nuys Prognostic Index may be used to help your doctors determine the best treatment for your DCIS.
Invasive breast cancer- the disorderly growth of cells when left untreated can spread outside of the breast to other organs of the body. It is named by the cells from which the cancer originates. Invasive ductal carcinoma when it originates in the ducts and invasive lobular carcinoma, when it begins in the lobules.
How to read your initial pathology report
Your initial pathology report will contain important information, but not all of the information that you will need. The initial report will tell you the type of cancer.
The basic type of cancer
Insitu –Ductal Carcinoma Insitu (A cancer confined to the ductal structure that has not invaded the surrounding breast tissue)
Invasive ductal carcinoma (cancers originating in the ducts)
Invasive lobular carcinoma (Cancers originating in the lobules)
Invasive ductal carcinoma with lobular features
The Grade of the tumor
(how aggressive it appears under the microscope)
Grade I – low grade or slow dividing cells
Grade II- intermediate grade moderate cell division
Grade III- high grade or rapidly dividing cells
Tumor prognostic factors ( + or -)
ER (Estrogen receptors) determine the tumors response to estrogen stimulation
PR (Progesterone receptors)
Her 2 neu
Ki67
s-phase
Your Final Pathology Report
In addition to the information on the initial report, the final report will contain information about the pathologic stage of the cancer.
Stage I-IV
T- for the tumor size
N-nodal status (whether-or-not the breast cancer cells have spread to the lymph nodes)
M –will likely be reported as M x unless the pathologist has knowledge that the tumor was not identified elsewhere in the body then it will be reported as M 0. M1 means that the cancer has spread to a part of eth body away from the breast and lymphnodes under the arm.
margin status will also be listed and this will tell you how far the tumor was from the edge of the specimen (ie. The tissue surgically removed)
We encourage you to visit www.breastcancer.org and type in your pathology to obtain an understanding of your personal pathology report.
