Step 3: Understand Your Lab Results
Biopsy results usually arrive in dribs and drabs over the course of days or even weeks. Together, they make up your pathology report—a document that can seem like it's written in a foreign language. But if you do have cancer, you'll want to make sense of it, since it's key for deciding what treatments will be best. A "translation" of important answers your report contains:
The Fine Print on a Benign Biopsy
- What type of cancer do I have? You'll probably find it described in one of the following ways:
DCIS (ductal carcinoma in situ): About 20% of new cancer cases are this noninvasive type, which arises in the ducts or tubes that carry the milk to the nipple and hasn't traveled to other parts of the body. Nearly all women diagnosed with DCIS can be cured.
IDC (invasive ductal carcinoma): The most common kind of breast cancer, it starts in the ducts, invades fatty tissue of the breast, and can spread to other parts of the body. Still, more than 97% of women with early-stage IDC overcome it.
ILC (invasive lobular carcinoma): About 10% of invasive breast cancers start in the glands (lobules) that produce milk. ILC is often found at a later stage than IDC because the milk glands are deeper in the breast tissue than the ducts, which makes ILC harder to detect by touch and mammogram.
- How aggressively is it growing? You can tell by your cancer's "grade," which is on a scale of I to III. A "I" has the slowest-growing, least aggressive cells; III spreads the fastest.
- What's the hormone receptor status? Some breast cancer cells have hormone receptors—molecules that allow estrogen or progesterone (or both) to activate the cells. The good news is that several new therapies block the hormones from reaching the receptors.
- Does the cancer contain the HER2 gene? Tumors that are HER2-positive tend to grow rather fast, spread quite quickly, and may need more aggressive, specialized treatment.
- What stage is the cancer? To describe how big the cancer is and how much it has spread, doctors use a scale of 0 to IV. The lower the number, the less extensive the cancer. More tissue may need to be removed (and lymph nodes tested) before you learn your cancer's stage.
Don't breathe a sigh of relief: Some types of noncancerous lumps increase your chances of breast cancer in the future. In a study of 9,000 women, those whose benign biopsies revealed excessive or atypical cell growth were four times as likely to develop cancer in the next 15 years as those whose biopsies showed no abnormalities. "'Negative' is not a complete answer," says Stuart Schnitt, M.D., director of anatomic pathology at Beth Israel Deaconess Medical Center in Boston. "Ask for details and find out if you should have more frequent examinations and mammograms or consider preventive drug therapy."