After a day of digesting the big news, I got myself to start understanding the important document in a cancer diagnosis, the pathology report. It is the result of the biopsy done from the breast mass taken four days ago.
I have never seen a cancer pathology report before so the terms were all new to me. For those who gets the diagnosis, I've learned this one of the important information to help you understand your condition. It's not yet complete since I'm still waiting for some more tests, but it says the big picture so far.
I searched a lot to find a source on how to understand it in layman's terms. I hope I can help someone by sharing these info in the simplest way I have understood it.
My Pathology report :
Anatomic site/Laterality/Procedure: Right breast mass, 14 Gauge Core biopsy
Histologic Type / Grade: Infiltrating Ductal Carcinoma with focal necrosis, moderately-differentiated, Grade II
Modified Bloom-Richardson Scale: 7 out of 9 Points
Tubule Formation: 3 out of 3 points
Nuclear Pleomorphism: 2 out of 3 points
Mitotic Count per 10 high power fields: 9 out of 10; 2 out of 3 points
Invasive tumor size: Involves all four cores
The grading system used in the pathology report is the Bloom Richardson system. According to
The Bloom-Richardson grading system,or the modified Bloom-Richardson-Elston grading system,is a breast cancer staging system that examines the cells and tissue structure of the cancer to determine how aggressive and invasive the cancer is:
What percent of the tumor makes normal duct structures? In cancer, there is a breakdown of the mechanisms that cells use to attach to each other and communicate with each other, to form tissues such as ducts, so the tissue structures become less orderly. (MINE IS 3 OUT OF 3)
How many mitotic figures (dividing cells) can the pathologist see in a microscope field? One of the hallmarks of cancer is that cells divide uncontrollably. The more cells that are dividing, the worse the cancer. (MINE IS 9 OUT OF 10)
Are the cell nuclei uniform like normal breast duct epithelial cells, or are they larger, irregular, and darker (pleomorphic)? In cancer, the mechanisms that control genes and chromosomes in the nucleus break down. Irregular nuclei are a sign that the mechanisms that control cell reproduction are breaking down. (MINE IS 2 OUT OF 3)
Each of these features is assigned a score ranging from 1 to 3. The scores are then added together for a grade that will range between 3 to 9. This value is then used to grade the tumor as follows :
3-5 Grade 1 tumor (well-differentiated). Best prognosis.
6-7 Grade 2 tumor (moderately-differentiated). Medium prognosis. (MY SCORE IS 7)
8-9 Grade 3 tumor (poorly-differentiated). Worst prognosis.
Lower grade tumors, with a good prognosis, can be treated with less aggressive surgery and medication, and have a better survival rate.
Higher grade tumors must be treated with more aggressive surgery, radiation, and drugs with worse adverse effects, and have a worse survival rate.
Looking at it as glass half-full, at least I'm at the "moderately differentiated" grade tumor. Score of 7, Grade 2.
It could have been worse so I am grateful and hopeful for a good survival rate and treatment.