After lumpectomy? What's next?

The weak positive ER and weaker positive PR could mean that estrogen blockers won't be as effective, but they may also still be prescribed since you are not negative. I am not sure who those numbers will affect your Oncotype.

I just googled all the terms, which you can also do- and ask your doctor about this info. I am only posting to help you collect questions and am just a fellow cancer (former) patient.

1) The papilloma and the PASH are both not cancerous. (You can google these.) So that's good news!

Comedo type DCIS is aggressive as you can see from the grade 3 and apparently you want to make sure that it hasn't pushed further out if it is greater than 2.5cm. I assume "occult infiltration" means infiltration not seen on imaging but I don't know if it is seen in pathology : https://radiopaedia.org/articles/comedo-type-ductal-carcinoma-in-situ-4?lang=us

"Comedo-type DCIS completely fills and dilates the ducts and lobules of the terminal duct lobular units (TDLU) with plugs of high grade tumor cells with pleomorphic nuclei and central necrosis ("comedonecrosis").

Infiltrating ductal carcinoma (infiltrative ductal carcinoma with central necrosis) may so closely mimic the pattern of DCIS with central comedonecrosis that on initial morphological analysis these foci of tumors are often labeled as DCIS (high grade, comedo-type).

There is a risk of occult infiltration. A comedo that extends for >2.5 cm has an invasive component in 45% of cases."

I saw surgeon first (after seeing PCP) and had biopsies. When biopsy results came back my surgeon referred me to see medical oncologist and radiology oncologist because my case was going to be discussed with hospital “tumor board” to discuss best path forward. After recovery from surgery I just had to contact medical oncologist to begin chemo and then called radiology oncologist to schedule simulation. I don’t know if this is how other surgeons do it, but mine is stellar, I literally owe my life to him. He and his nurse navigator made sure I understood what needed done, why it needed done, how and when it would be done-while taking time to answer questions, asking my input at each step.
Well! This was certainly long-winded! Find a surgeon you feel good about, ask around for other opinions. Don’t hurry this process. Best wishes to you in this very stressful time!

Thank you helping interpret these findings.

I will highlight questions for the surgeon pertaining to the comdeo component. And occult infiltration.

This helps so much.
Thank you.

Thank you it does help. I was just reading about Oncotyping.
I just have to keep asking questions.

Oncotype is KEY to treatment if you are Estrogen positive which is 80% of Breast Cancers.

A favorable Oncotype of under 25 for post menopausal women, 18 for pre-menopausal women, means CHEMO is NOT beneficial and therefore not administered. 🌸

Thank you.
Not sure what it means that I am 15% low positive and progesterone negative.
I guess when surgeon refers me to an oncologist I will find out if estrogen blockers would help me.

Not a health professional but my “understanding” is any amount ER+ is a candidate for hormone treatment. If HER2 + there is a monoclonal antibody as well. You will understand your treatment protocol very soon. Ask a lot of questions so you understand the WHY? of your treatment.

It’s bewildering how many “subtypes” of Breast Cancer there are. We each gave our own particular path on this unwanted journey.

Best to you and come back with questions ( and answers 😀) !