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 Understanding your pathology report
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Tricia Keegan

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Understanding your pathology report - Tuesday, April 14, 2009 3:44 PM
Understanding your pathology

  Breast cancer stage

Staging is based on the size of the tumour,whether lymph nodes are involved and whether the cancer has spread outside the breast. Your Dr use's all parts of the pathology
report as well as the stage of Breast cancer to shape your treatment plan.

Specimen  Where the tissue samples are taken from, the breast, lymph nodes or under your arm (axilla) or both.
Gross description   Describes the tissue samples ie- size,weight, and color.
Microscopic description How the sample looks under a microscope

Abnormal cells  cells that do not look or act like the healthy cells of the body
Aggressive cancer cells cells that are fast growing and can spread beyond the area where they started
Anti-her2 antibody therapy   A medicine called Herceptin used to treat breast cancer with abnormal her2 gene

Benign  Not cancerous
Clean margin  The area around the normal tissue is free of cancer cells
Close margin  The cancer cells come near the outer edge of the tissue around the tumour
Colloid A type of invasive cancer that grows into the normal tissue around it,usually slowly.
Comedo A type of non invasive cancer that usually does'nt spread, grows fast
Cribriform A type of non invasive cancer that does not spread and grows slowly.

Ductal Carcinma in situ   (DCIS)  Non invasive that stays inside the milk ducts and has not spread outside
ER Negative     A cancer that does not have Estrogen recepter's
ER Positive      A cancer that has Estrogen recepters.
FISH (Fluorescence in situ Hybridization) test   A test for the her2 gene
Grade Tells you how much the tumour cells look different from normal cells
Her2  A gene that helps control the growth and repair of cells
Hormone Recepters   Tiny areas on cells that listen and respond to signals from hormones
IHC  (Iimmunohistochemistry )A test for the her2 protein

In situ  A cancer that stays where it began in the breast and usually does'nt spread.
Invasive  A cancer that spreads beyond where it started
Invasive ductal carcinoma (IDC) A cancer that begins in the milk ducts but grows into the normal breast tissue around it
Irregular cells Cells that do not look like the healthy cells of the body
KI-67  A test that shows how fast the cancer is growing

Lymphatic invasion  Means cancer in the cells are found in the lymph vessels
Mucinous A type of invasive cancer which spreads into the normal tissue around it.
S Phase fraction test   A test that shows how fast the tumour is growing
Vascular invasion   means the cancer cells are found in the blood vessels

HER2 Testing-

There are 2 types of tests available to determine HER2 status: Fluorescence In Situ Hybridization (FISH) and ImmunoHistoChemistry (IHC).
  • A FISH test checks to see whether or not the cancer cells have a normal number of HER2 genes. Using a special microscope the pathologist looks at cancer cells to see how many HER2 genes there are compared with some other normal genes
    • If there are 2 or more HER2 genes for each normal gene in the cells (that is, if the ratio is =2.0) the tumor is HER2+
  • An IHC test measures how much HER2 protein there is on the surface of the cancer cells. The test is scored on a scale of 0 to 3+
    • A patient who has a tumor with a score of 3+ is considered to have HER2+ breast cancer
    • The National Comprehensive Cancer Network guidelines recommend that a tumor with a score of 2+ should be retested with the FISH test to determine whether the tumor is HER2
Some useful staging info-

N.B....Your surgeon ideally should go over your path report with you and explain it in detail while answering any questions. if there's something you're not sure of please contact your Dr to explain in more detail.
The above is meant as a rough guide for patients but should not take the place of a Dr's explanation on your own particular pathology report.

A useful site for helping make decisions on treatment and knowing what to ask for is -


<message edited by Tricia Keegan on Tuesday, October 04, 2011 3:24 PM>
Tricia Keegan...From Ireland Dx July '05 IDC 3/9 nodes pos..triple positive..a/c x 4..Taxol/herceptin x 12
Herceptin 1yr ..rads x35 oophorectomy Aug '06
Currently taking Arimidex /Zometa 1 x yearly
Carepage- survivortricia

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