Translation help

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1

Hi,

I have just been reading through my pathology report and think I understand most of it but there are a few bits I don’t. Can anyone help cos I can’t find out the info or enough on the “Understanding your Pathology” booklet?

Breast tissue showing Grade I invasive ductal carcinoma with intermediate nuclear grade DCIS. It measures 18mm in maximum dimension, no lymphovascular invasion is seem, the nearest (anterior) margin is at 1.2 mm.

I get the Grade I invasive ductual bit but what is the nuclear grade DCIS? Is the DCIS part of the 18mm? What is the margin bit about?

The report then goes on to say

8 lymph nodes are identified. One of these shows micrometastasis. One lymph node is identified and this is free of tumour.

Why is the 9th lymph node mentioned separately and as being free of tumour? Why isn’t it lumped in with the other 7 presumably tumour free ones in the 8?

The report then goes on to say

In situ carcinoma : present
ductal : yes
Grade : intermediate
Growth pattern : cribiform
lobular : no
pagets : no
microinvasion : no
invasive carcinoma : yes
tumour grade : 1
tumour type : ductal
tumour extent : localised
vascular invasion : not seen (blood or lymphatic)

I think this means/confirms above that I have/had a no specific type ductal invasive carcinoma Grade I and also a ductal in situ carcinoma intermediate (is that DCIS?) and that no lobules were involved and I dont have Paget’s disease and no spread to my blood or lymphatic system but…

What stage is this? I or II (with the lymph node which they then go on to state out of the 9 lymph nodes 1 is positive)

What on earth is cribiform growth pattern? The booklet on here seems to say its another unusual type of cancer.

What is micro invasion?

More, sorry, the report then goes on to say

umour size 18.00 mm (largest dimension of dominant invasive tumour focus), whole size of tumour 18.00 mm (to include DCIS extending >1mm beyond invasive area

Was my tumour a mixture then?

Nearly there, the report then says

Excision margins : does not reach margin. Anterior/superficial : 1mm

Eh? Is this because I had a mastectomy and my tumour was under my nipple so margins not an issue?

And finally,

Report says Tumour stage : pt1, N1mi

Eh???

Sorry, a long post, have been trying to understand it all day and would appreciate anyone who can explain some or all of it to me in terms I might get. Nothing in the report re receptor status so still have to wait for that and then figure that out.

Phew!

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Forgot to say, I do have appt with oncologist on Monday who may be able to answer these questions but I wanted to try and figure them out myself first so I could ask him any further questions that arose.

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Dear Ostrich

Please feel free to call our helpline where our specialist breast care nurses will be able to go through your results with you and help you to understand them. The line opens Monday to Friday 9am-5pm and Sat 9am-2pm on 0808 800 6000.

Best wishes
Lucy

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Let us know what it all means when you find out!
Mine seemed more straightforward than that!
Sorry I can’t help,
Dot
xx

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I never got mine and not sure i want it but did you ask for it or was it offered to you?
Rx

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Hi there, The only comment I can make is that your invasive tumour was a grade 1 (great), and your dcis was a grade 2 (o.k.) The bit about lymph nodes was confusing and i would ask for an explanation!
Good luck to you- mine was a grade 2 and a similar size!
Julie XXXX

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Re my post above, I managed to get some answers, some I didn’t or can’t remember what the onc said cos I was more interested in my receptor status and treatment.

Don’t know which stage, not sure if it matters, am being treated as node positive because of my micrometastases. Cribiform is apparently the pathologist’s explanation of the growth pattern of my cancer in that it grows in a network I think rather than a clump. Not sure I asked what micro invasion was or whether he said it was invasion of the DCIS outside of the ducts which there isn’t. My tumour was a mixture of DCIS and invasive cancer. Dont think I really understood his answer other than as they removed my whole breast clearance not an issue but he did say something about the anterior bit being in relation to the chest wall. Tumour stage bit says something along the lines of stage 1 (answering my first point that I don’t know) and that there was one micrometastase (is that the singular).

Sorry if I haven’t helped answer anyone’s questions!

The only thing I remember clearly other than that I am strongly prog and oest + and her2 - (and my OH wasn’t interested in the answers to my questions on the report so can’t remember) is that he said that the lymph nodes are like a ladder. I asked about the fact that I didn’t have SNB and full axilliary clearance and how could they be sure that the other ones left behind (they took 9 with 1 with micro mets) hadn’t got some cancer. He said the lymph nodes are like a ladder and the surgeon would have taken out the bottom rung/rungs so if only 1 in those had micromets the chances of higher rungs having anything were slim to non existent.

Liverbird, I asked for a copy of mine from the BCN and she sent it the post.

xx