For early breast cancer, the diagnosis is ‘invasive breast cancer’ or ‘invasive breast carcinoma’.
If the cancer is in the ducts of the breast, it’s called invasive ductal carcinoma. If cancer is in the lobules of the breast, it’s called invasive lobular carcinoma. If early breast cancer involves the nipple area, it’s called Paget’s disease of the nipple.
The pathology report
After a biopsy or breast surgery, the cells or tissue are sent to a pathologist. The pathologist looks at the cells or tissue under a microscope and writes the results in a pathology report. This will usually take a couple of days. Information in the pathology report helps with treatment planning.
Information in the pathology report is used to determine the stage of the breast cancer. The stages used to describe early breast cancer are Stage I, Stage IIA or Stage IIB (2–5cm).
Some women find it helpful to keep a copy of their pathology report so that they can refer to it later.
What does the pathology report mean?
The pathology report contains information about a woman’s breast cancer that helps when making treatment recommendations. Some of the information in the pathology report will only be available after breast surgery or surgery to the armpit.
The pathology report usually includes the following information:
Size and location
The report shows the size of the breast cancer and where it is in the breast. This will affect what treatments are recommended, including the type of surgery.
The report shows whether breast cancer is positive or negative for hormone receptors. About two-thirds of women with breast cancer have hormone receptor-positive breast cancer. This will affect whether hormonal therapies are recommended.
The report shows whether there are HER2 receptors on the breast cancer. This is called the HER2 status and will affect whether targeted therapies such as trastuzumab (Herceptin®) are recommended. About one in five women with breast cancer have HER2-positive breast cancer.
The report shows whether there are cancer cells in the lymph nodes in the armpit (axilla) or near the breast. This information will usually only be available after surgery to the armpit and may affect whether chemotherapy is recommended.
During breast conserving surgery, the surgeon removes the breast cancer and an area of healthy looking tissue around the cancer. The healthy looking tissue is called the surgical margin. If there are no cancer cells in the surgical margin, it’s likely that all the cancer has been removed. In this case, the surgical margin is said to be ‘clear’. If the surgical margin is not considered to be ‘clear’, more surgery may be required to ensure that all of the cancer is removed.
Grade of breast cancer
The grade of the breast cancer shows how fast the cancer cells are growing. The cancer grade is numbered from 1 to 3. A low grade (Grade 1) means that the cancer is growing slowly. A high grade (Grade 3 means that the cancer is growing more quickly.
The higher the grade means the cancer is more active. This means it’s more likely the cancer has spread outside the breast and armpit area. The higher grade means that it’s more likely that systemic treatments (treatments that affect the whole body, such as chemotherapy, hormonal therapies and targeted therapies) will be recommended.