Specimen Information

Type of Specimen:

• Biopsy: A sample of tissue taken from the body for examination.
• Lumpectomy: Surgical removal of a tumor and a small margin of surrounding tissue.
• Mastectomy: Surgical removal of one or both breasts, partially or completely.

Location of Specimen:

• Left breast: Specimen taken from the left breast.
• Right breast: Specimen taken from the right breast.

Number of Specimens Submitted:

• 1 specimen: One tissue sample submitted for analysis.
• 2 specimens: Two tissue samples submitted for analysis.
• 3 or more specimens: Multiple tissue samples submitted for analysis.

Gross Description

Size of the Specimen:

• 3 cm in diameter: A small-sized specimen.
• 4 cm in diameter: A medium-sized specimen.

Weight of the Specimen:

• 20 grams: A lightweight specimen.
• 25 grams: A slightly heavier specimen.

Description of the Specimen:

• Pink, firm tissue with areas of necrosis: Describes the color, consistency, and presence of dead tissue areas.
• Yellowish, soft tissue with multiple masses: Describes the color, consistency, and presence of multiple lumps.

Microscopic Description

Type of Cancer:

• Invasive ductal carcinoma: The most common type of breast cancer that begins in the milk ducts.
• Invasive lobular carcinoma: Cancer that begins in the lobules (milk-producing glands).
• Ductal carcinoma in situ (DCIS): A non-invasive cancer where abnormal cells are contained in the milk ducts.

Histologic Grade:

• Grade 1 - Well-differentiated: Cells look more like normal cells and tend to grow and spread slowly.
• Grade 2 - Moderately differentiated: Cells look less like normal cells and grow slightly faster.
• Grade 3 - Poorly differentiated: Cells look very different from normal cells and grow quickly.

Microscopic Description

Tumor Size:

• 1.5 cm: A small tumor.
• 2.3 cm: A medium-sized tumor.

Tumor Margins:

• Clear: No cancer cells at the edges, indicating complete removal of the tumor.
• Positive: Cancer cells present at the edges, indicating incomplete removal of the tumor.

Lymphovascular Invasion:

• Present: Cancer cells found in blood vessels or lymph vessels.
• Absent: No cancer cells found in blood vessels or lymph vessels.

Hormone Receptor Status

Estrogen Receptor (ER) Status:

• Positive: 75% of cells have estrogen receptors, indicating that the cancer may respond to hormonal therapy.
• Negative: Less than 1% of cells have estrogen receptors, indicating that the cancer is unlikely to respond to hormonal therapy.

Progesterone Receptor (PR) Status:

• Positive: 60% of cells have progesterone receptors, indicating that the cancer may respond to hormonal therapy.
• Negative: Less than 5% of cells have progesterone receptors, indicating that the cancer is unlikely to respond to hormonal therapy.

HER2 Status

HER2/neu (Human Epidermal Growth Factor Receptor 2) Status:

• Positive: IHC score of 3+, indicating overexpression of HER2 protein, which can influence treatment decisions.
• Negative: IHC score of 0, indicating no overexpression of HER2 protein.
• Equivocal: IHC score of 2+ with FISH testing required to confirm the status.

Ki-67 Proliferation Index

Ki-67:

• 30%: Indicates moderate cell division and may suggest a moderate growth rate of the tumor.
• 50%: Indicates high cell division and suggests a more aggressive tumor growth.

Tumor Markers

CA 15-3:

• Elevated: Common in breast cancer, used to monitor treatment response or recurrence.
• Normal: Indicates no significant elevation of this tumor marker.

CA 27.29:

• Elevated: Indicates possible progression or recurrence of breast cancer.
• Normal: Indicates no significant elevation of this tumor marker.

Other relevant tumor markers:

• CEA: Elevated in some cancers, can be used to monitor treatment response or recurrence.

Lymph Node Involvement

Number of Lymph Nodes Examined:

• 10: A typical number of lymph nodes examined during surgery.
• 15: Indicates a more extensive examination of lymph nodes.

Number of Lymph Nodes Involved with Cancer:

• 2: A small number of lymph nodes involved.
• 4: A moderate number of lymph nodes involved.

Size of Largest Metastasis in Lymph Node:

• 1 cm: Indicates a small metastasis in the lymph node.
• 2 cm: Indicates a larger metastasis in the lymph node.

Molecular Testing

Genetic Mutations:

• BRCA1 positive: Indicates a genetic mutation associated with increased risk of breast and ovarian cancer.
• BRCA2 positive: Indicates a genetic mutation with similar risk implications to BRCA1.
• PIK3CA: Common mutation in various cancers, including breast cancer, and can influence treatment.
• TP53: Mutation associated with many types of cancer, including breast cancer.

Genomic Assays:

• Oncotype DX: Provides information on the risk of recurrence and can help guide treatment decisions.
• MammaPrint: Provides information on the risk of recurrence and can help guide treatment decisions.