Understanding Your Test Results

Receiving a mammography or pathology report can sometimes feel overwhelming, with complicated medical language and unfamiliar information. At the Carol Ann Read Breast Health Center, we’re here to help. Your doctor, nurse navigator and COMPASS guide can help you understand your test results, as well as your next steps. Here are some terms to get you started.

Benign Breast Conditions

During a clinical breast exam or routine mammography, your doctor may find an abnormality, but it’s important to remember that it may not be life threatening.  These benign breast conditions, however, may indicate an increased risk for breast cancer, so your doctor may order more testing to confirm your diagnosis and prescribe treatment, if needed.

Some common types of benign breast disease are:

• Cyst
• Fibrocystic breast condition
• Fibroadenoma

• Intraductal Papilloma
• Breast pain

Pathology Reports

When a sample of your breast tissue is removed during a needle biopsy or surgery, a pathologist will examine it thoroughly and write a report to let your doctor know if the cells are cancerous. At our center, a second pathologist will also review any cancerous tissue to confirm the diagnosis.

Remember that each cancer is different. Your pathology report is a personalized description from which your doctors will base their future treatment.

Since the written report is intended for your doctor, it’s quite comprehensive and written in medical language. If your diagnosis is malignant, the following details will be included in your report:

• Size
• Gross Description — A description of what the sample looks like to the naked eye.
• Microscopic Description — A description of what the sample looks like under a microscope, a biological evaluation, and information about the size of the cancer, the extent of the disease, and the exact type of tumor.
• Invasive vs. Noninvasive — Once a cancer cell has broken through the membrane of either a duct or lobule, it is considered invasive. Non-invasive cancer is considered in situ; it cannot spread to your lymph nodes.
• Histologic Grade — This indicates the type of cancer, the arrangement of the cells and how aggressive the cancer is.
• Surgical Margins — Pathologists mark the edges of a sample with ink before cutting it so that when they examine it under the microscope, they can measure how close the cancer is to the edges. Sometimes if the margin is too close to a cancer, your doctors may recommend more surgery.
• Lymph Node Status — Tumor cells can travel to other parts of the body through lymph nodes and vessels, which your doctors may remove to see if the cancer has spread. This part of the report indicates how many lymph nodes they removed and if they found cancer cells.
• Hormone Receptor Status — Breast cancer cells can have a high number of estrogen and/or progesterone receptors. If your cells have a higher rate of estrogen receptors, they are ER positive, while progesterone receptors are PR positive. If the receptors are low in number, the cancer is ER or PR negative. This helps your doctor determine what therapies would be most effective.
• Her2/neu Status — This indicates how sensitive the cancer cells are to a particular growth factor, which could speed up the way they spread. Reported as a positive or negative attribute, it can help your doctors identify which therapy would best treat the cancer.
• Lymphovascular Invasion — Cancerous cells can penetrate blood vessels and lymph channels. The rate at which this is occurring can inform your doctors about how the cancer cells are spreading.

Different institutions sometimes use different formats for the report. The information can be confusing, so ask your doctor to review your pathology report with you.