Breast Cancer Education: Breast Biopsy

Not all breast cancers are the same. A biopsy is needed in order to diagnose breast cancer. Once biopsied, cells are sent to a lab for a pathology report. The following information will usually be available on this report if the cells studied are cancerous:

• Diagnosis: This is the most important part of the pathology report. It gives the final diagnosis and may include information on the cancer such as tumor size, type, grade, etc.
• Tumor Size: Tumor size is most often reported in centimeters. In general, the smaller the tumor the size, the better the prognosis.
• Non Invasive vs. Invasive: Status will be on the report.
• Tumor Grade: For invasive tumors, the shape is noted and a grade is assigned. Tumor grade relates to the structure of the cells. It is different from tumor stage. This determines how different the cancer cells look from healthy cells.
• Grade 1: Cells look most similar to normal and are not growing rapidly.
• Grade 2: Cells look somewhat different than normal.
• Grade 3: Cells look irregular and may be spreading/growing aggressively.
• Tumor Margins: An area of normal breast tissue around the suspicious area will be taken out to be sure the entire tumor is removed. A report will show positive, close, or negative margins.
• Positive: Margins contain cancer cells.
• Close: Cancer Cells approach but do not touch the edge of the biopsy.
• Negative: The margins do not contain cancer cells
• Lymph Node Status: If lymph nodes were removed a pathology report will show if the lymph nodes contain cancer cells.
• Hormone Receptor Status: Hormone receptors are proteins found inside some cancer cells. When hormones attach to these receptors, they make cancer cells grow. Knowing the hormone receptor status will help guide your treatment.
• Estrogen and Progesterone Receptive-positive (ER+ and PR+) tumors have many hormone receptors.
• Estrogen and Progesterone Receptive-negative (ER- and PR-) tumors have few or no hormone receptors.
• HER2/neu Status: human epidermal growth factor receptor 2 is a protein that occurs on the surface of some breast cancer cells. About 15-20 percent of breast cancers are Her2+. These breast cancers tend to be more aggressive than other tumors.
• HER2/neu-positive (HER2+) tumors have many HER2/neu genes inside the cancer cells (also called HER2/neu over-expression), which causes a large amount of HER2/neu protein on the surface of the cancer cells
• HER2/neu-negative (HER2-) tumors have few HER2/neu genes inside the cancer cells and little or no HER2/neu protein on the surface of the cancer cells
• Triple Negative: If all three statuses are negative (ER, PR, and HER2/Neu) then the patient’s cancer is Triple Negative Breast Cancer. The current standard of treatment for these cancers is limited to chemotherapy. These cancers tend to be very aggressive and reoccur early.

Learn more about breast biopsies: http://ww5.komen.org/BreastCancer/Biopsies.html

Learn more about types of breast cancer tumors: http://ww5.komen.org/uploadedFiles/Content_Binaries/806-369.pdf