Biopsy Results

 Well, there it is.  It's cancer.  

• Invasive ductal carcinoma (IDC) of no special type, Nottingham grade 2-3.  
• Focal ductal carcinoma in situ (DCIS), intermediate nuclear grade, with associated focal necrosis.
• Breast biomarker studies:
• Estrogen receptor: Positive (moderate staining, >90%).
• Progesterone receptor: Positive (strong staining, >90%)
• HER2/neu: Negative (score 1+)

Finding was malignant, concordant.

The hospital sends lab results to you in the patient portal as soon as they are available. While I waited for the follow-up call I spent a lot of time googling the terminologies in the lab results. None of it sounded good.

Here is what I have learned (keep in mind I'm no doctor):

• IDC is the most common type of breast cancer, originating in the milk ducts.
• "Grade" determines aggressive potential of cancer. It's rated on scale of 1-3 with 3 being the worst.
• DCIS is a non-invasive form of early stage breast cancer known as stage 0. It is common for IDC to have an accompanying DCIS component.
• Estrogen and Progesterone receptor positive (HR+) means my cancer feeds on these hormones. Majority of the breast cancer cases are HR+. Women with this type of cancer cannot take birth control pills or get hormone replacement therapy (HRT) when they reach menopause.
• Since I am HER2 negative, I don't know much about this indicator. It seems HER2 positive cancers are more aggresive.

Next step: Surgical referral.

Biopsy

The ultrasound guided biopsy was under local anesthesia.  The anesthetic injection was the most painful part.  The needle they use to collect the samples can be felt as a tug occasionally.  Not very comfortable.  I felt upset that I had to go through something I felt was invasive.  I cried a little.  

During the biopsy the doctor places a titanium clip in the location of the biopsy.  The reason for this is two fold.  First, if biopsy results showed the tumor to be benign, doctors reviewing future mammograms will know the mass has already been tested.  Second, if biosy results showed malignancy, thus requiring surgery, the surgeon would be able to find the mass more easily with the clip.

The unforunate part of biopsies is that it takes like a week to get biopsy results since they have to see in the lab how fast the cells grow/split over time.