Breast biopsy: The results are in

Hi Zebra,

Thank you so much. Just received my results. I have invasive duct Al carcinoma. Im a nurse and have no knowledge of what I’m looking at on my path report. Would you assist me in understanding?

1. My estrogen receptor was positive at over 90.. Is this a good sign?

2. My progesterone states moderate at 10-20. Is this a good or bad sign?

3. My Nottingham score was 7 out of 9. My combined grade was 2/3. Nuclear atypia 3/3, tubule formation 3/3 and miotic activity 1/3. Thoughts? The PA told me my tumor is a grade 2?

4. The PA I met with today had this same breast cancer 6 months ago. She told me based on my report I was HER2 negative. However, on my report is says “Her 2 equivocal at 2 +”. I don’t understand how she could say I was HER2 negative when I was equivocal?

Any thoughts would be much appreciated.

Denise

Hi Denise @denise66

I'm so sorry it turned out to be cancer. I'm curious what your PA had to say about all the details. Who are you meeting with next and when? Will they do genetic testing?

We need to bring others more recently diagnosed with BC in to help interpret all this because back in 2013 when I was diagnosed, they didn't provide all this detail and various scores -- at least my team didn't. I was just told mine was PR+ ER+ HER2- Invasive Ductal Carcinoma, medium grade, 7 mm. My surgeon said my tumor had a favorable personality.

As for the HER2 issue, I just looked it up and saw that 3+ is considered positive. 2+ is borderline. Not sure how that impacts treatment decisions.

ER/PR positive means it will benefit from hormone blockers since hormones are BC fuel.

Medium grade is much better than high grade.

I'm as eager as you are to hear input about the scores you listed above. Let's pull in some more people by listing their user name. Can any of you shed some light?

@squeaker2 listed some of the same type scores you did.

I'll add others that have BC and have been commenting on posts. They may or may not have received or know about such detail depending on era. Or they may have been on this site longer to see others comment about these.

@windyshores @katrina123 @tctredwell1 @auntieoakley @katho3 @allusernamestaken @bpkintter53 @annkitz @vivi1 @colleenyoung @christie73 @heydon2023 @polianad22 @bjjoyce1 @galbooboo @cgraft @dolphina3 @snowdown @lisakinpa

Zebra,

Thank you so much.

I received my diagnosis in June of last year. I wasn’t comfortable with the breast surgeon at the time and got a second opinion. The diagnosis was DCIS in both breasts and my left breast has 99% sensitivity to estrogen. After healing from the surgery, I decided on radiation since the numbers for recurrence were so much lower. I finished radiation last month and I’ve been on the hormone blocker Anastrozole since May 1st. I followed the suggestion of someone in this group to take it at bedtime since it can make you sleepy. Hope that helps.

Hello @denise66 , I remember this crushing blow like it was yesterday. What was even more disturbing was everyone around me being really nonchalant about it. This is devastating to the person receiving the diagnosis, although I cannot offer the hug, I would like to give you. Grab a cup of tea, and I will try and translate some information. You should still ask your doctor these exact questions, as they will likely have a more complete and better answer for you.
Estrogen positive over 90% means this is “druggable” target with which to treat this cancer. This is where hormone therapy is really helpful.
Progesterone seems like a normal range.
Her2 is not over-expressed, meaning that some percentage is normal, I just now looked at my friends path report and it said negative at 25% expression. However her2 is another “druggable” target.
Grade 2 of 3 meaning right down the middle in terms of aggressive behavior and growth rate. Not the slowest but not the fastest.
In terms of the awful, this is less awful than many, if only because it has ways to treat it.
Have a good cry, and let yourself feel the impact. There is work ahead, but that is for another day.
I will be thinking about you.💕

Hi Denise @denise66

I agree with @auntieoakley that it's surreal to actually get the BC diagnosis. The next few weeks will also be hard while you wait for each appointment or additional labs/scans to continue to iron out the details of your cancer and provide you with treatment options. I found having a set plan and being on the other side of surgery was a huge relief so I could just move forward and get back to my life and new normal. Hang in there and ask lots and lots of questions.

Hugs, Zebra

Hi Denise @denise66

How are you doing? Have you had any more appointments with further explanation of your findings or plan?

Zebra

@denise the high estrogen score is a good thing! With equivocal HER 2 (I had that too) they retest with FISH. Is that on your report?

You will have an Oncotype test if you are HER2- and that will guide your treatment.

I was also grade 2/3 and had a low Oncotype so I only did surgery and aromatase inhibitor medication. Let us know what happens!

Hello @denise66 I have been thinking about you and wondering how you are doing. Have you gotten any more information from your doctors? Any plans yet?

In 2014, I was diagnosed with triple positive breast cancer which means ER+ PR+ HER2+. The tumor was just over 1 centimeter. These markers meant treatable. The doctors told me "treatable and curable" the first day and I believed them. And, they were right. I was clear after 6 chemos. I continued infusions for the HR (which aren't debilitating like chemo) for a year. I also had a lumpectomy and radiation. I took Anastrozole for 5 years. Chemo is scary and debilitating, but it works. Your doctor will choose the treatments that are right for your particular markers. I wish you well. It's a good sign that your PA was back to work in 6 months.