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Dr. Brims
Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9610
Experience:  U.S. Licensed Physician, general surgery and internal medicine experience
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Please explain the following pathology report results. two

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Please explain the following pathology report results. two breast samples were taken from the right breast. PLease advise if hormone therapy will help based on the receptor results. The results were as follows:

Sample A:
Infiltrating ductal adenocarcinoma, mBR grade 2
no definitive lymphovascular invasion seen
adjacent ductal carcinoma (DCIS), nuclear grade 2-3
Estrogen receptor score (ER)= 0
Progesterone receptor (PgR) score= 0
HER-2/neu score 2+
ki67 score= 28

Breast Sample B:

Infiltrating ductal adenocarcinoma with lobular features, mBR grade 2
no definitive lymphovascular in vasion seen
ER score=70; intensity= variable, pattern= diffuse
PGR score= 100, intensity= strong, pattern = diffuse
HER-2/neu score= +1
ki67 score = 20

Dr Brims :

Hello, welcome to Justanswer, I will try to assist you with your medical question, and any medical information you seek

Dr Brims :

There are 2 samples

Dr Brims :

Both show invasive ductal carcinoma, which is the most common type of breast cancer

Dr Brims :

Can you see my replies?

Customer:

yes

Customer:

What do the ER, PgR and Her results mean?

Dr Brims :

The first sample is estrogen receptor negative with a score of 0, but the 2nd sample is positive with a score 70 andpgr score of 100

Dr Brims :

This mans it will likely respond to hormone therapy

Dr Brims :

Those score determine if it will respond

Dr Brims :

If they are positive, it is good

Customer:

what does ki 67 score mean and the HER-2/neu score mean and what type of hormone therapy do they suggest?

Customer:

Do the results suggest stage 1 cancer?

Dr Brims :

The HER /Neu score means that the genes neu are over exprssed and causing the cnacer to grow,

Dr Brims :

You have ductal carcinmoa in situ or DCIS, which is prior to stage 1, not stage 1 yet

Dr Brims :

Can you still see my replies ?

Customer:

if the the dx states invasive, then doesn't that mean it is beyond the cancer is no longer "in situ" ?

Customer:

Hasn't it spread to teh surrounding tissues as noted in the second sample taken?

Dr Brims :

It states no ductal invasion in the first sample, and the second has ductal invasion, so the first sample is DCIS, the 2nd is stage 1

Customer:

what do the "ki67" pathology scores mean?

Dr Brims :

KI 67 is a tumor marker that affects cancer growth

Dr Brims :

Your score is 28 and 20

Customer:

it stated the Estrogen receptor intensity was variable and the pattern was diffuse- what does that mean?

Dr Brims :

That is low, which is good

Dr Brims :

It means that some receptors were sensitive and some were not sensitive, and the pattern is spread out

Customer:

regarding the Ki67 values, since the scores are low and you said it good-what does that mean in terms of treatment?

Dr Brims :

It means that you will benefit from hormone treatment, likely an anti-estrogen and radiation

Customer:

regarding the progesterone receptor results, the intensity was strong and the pattern was diffuse-does that mean the receptors are highly sentive to that hormone and the pattern is spread out in that sample?

Dr Brims :

Yes, that is correct

Customer:

Ok, so will an anti-estrogen and anti-progesterone hormone treatment be of benefit?

Customer:

What is the survival (mortality) rate for this type of cancer found in the early stages?

Dr Brims :

Anti progesterone does not really help, most breast cancers respond to anti-estrogen treatment, because estrogen usually causes tumor growth

Customer:

One sample was discribed as having lobular features-is this type of cancer cell worse that the ductal cancer cells?

Dr Brims :

Lobular features are not worse

Dr Brims :

They are just describing the cells

Dr Brims :

Are you there?

Customer:

yes i'm here-last question-what is the survival rate for stage 1 cancers tthat are treated with hormones and radiation?

Dr Brims :

88%

Dr Brims :

Wait please

Dr Brims :

They will use radiation and hormones AFTER they have removed the tumor through surgery

Dr Brims :

Then the survival rate is 88%

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