Know and understand your Pathology report. Ask for a copy to keep in your files, and become familiar with it.
This is one of the most important things you should remember when you’re diagnosed with breast cancer (or any kind of cancer). Your pathology report is one of the most important documents you’ll receive as it drives all of your treatment options. If you’re like me, you probably never saw one before, let alone know what it means, so you’ll need to do a bit of research and become familiar with it. The information contained in your pathology report is very important to know and to remember, and there are some suggestions I have for how to keep this information handy. There are several things that are critical to know and remember:
1. Is your cancer invasive or non-invasive?
2. What’s the size of your tumor (in centimeters)
3. What’s the grade of your tumor (Grade 1, 2 or 3)
4. Hormone receptors: Is your cancer estrogen or progresterone positive or negative?
5. Is it HER2 positive or negative (or borderline)?
6. What is the Lymph node status: Positive (which means there is cancer in the lymph nodes. If positive, how many are engaged) or Negative (no cancer in the lymph nodes).
7. Is your cancer Ductal, Lobular or Inflammatory?
Genentech, in partnership with breastcancer.org (which is my favorite bc website), distributes a 3″x 9″ card-stock checklist covering all of these point, with boxes for you to fill in your specific information, which I received early on during discussions with the Breast care coordinator at my Medical Center (see a copy of it above). I filled it out after reviewing my pathology report with my surgeon, and then began to bring it with me to every subsequent appointment because invariably someone would ask me about one of the above points, and in the beginning, I couldn’t even remember them, let alone understand what they meant.
The way I absorbed the information on my pathology report was to have my doctor(s) explain it to me very carefully while I wrote things down. Then I went online and read about each of the different points. Then I read some brochures which explained the different details further, and then I read some studies, and then I read some books and then I went back online, until I actually began to have a sense of what was “good” or “bad” about my own results. Everything you need is on the web, search and you will find it. Sometimes I would have to read studies 3 or 4 times before I could really absorb the information, but eventually I felt I had a pretty good grasp of things from my research.
My pathology was: Stage 2 invasive lobular cancer, no lymph node engagement, ER and PR positive, HER2 negative and Grade 3.
Everyone kept saying how good it was to be Stage 2, how great it was to have no lymph nodes engaged and that it was good to be ER and PR positive and HER2 negative. But, I kept seeing that Grade 3 and from my research, I knew that wasn’t a great thing. It’s a scale of 1 to 4, and 3 is aggressive. Most people react to the stage of your cancer, but the grade seems to be very important too, as it shows how aggressively and quickly your particular cancer is growing. I also knew from my reading, that lobular breast cancer is less frequent but a bit more aggressive than ductal, so that also concerned me.
My point is, that when you know what your pathology report means, you have more information to help you make an informed decision in partnership with your oncologist and surgeon. And at the end of the day, YOU need to be your own “project manager” of this process, since no one really knows all of the specifics other than you.