Diagnosis

Hi Ann777

 Thank you for getting in touch with us, and welcome to the online community. I hope you find this to be a helpful and supportive environment. My name is Lynsay, and I am one of the information nurses with Macmillan Cancer Support.

I hope you are recovering well from your surgery. I am happy to go over your diagnosis with you prior to your follow up appointment. You are also more than welcome to call us on the support line if you have any further questions or if it would help to have a chat with one if us.

I will just go through this point by point and my apologies if I am covering information you already know. The first thing reported is the size of the breast cancer at 10mm. This information in combination with other factors identified in your pathology report is used to help guide your treatment plan. Generally anything under 20mm is considered small.

The grade of the breast cancer refers to how the actual breast cancer cells look under a microscope. The grade identifies how abnormal the cells look compared to healthy cells. The more abnormal the cells, the more potential they have to grow more quickly. Grade 1 is the lowest grade, and the cells are usually slow growing.

Invasive ductal carcinoma (IDC) identifies to the type of breast cancer found. There are different types of breast cancer,  IDC is the most common type of breast cancer.

Ki67 is a protein found in cells. It is often referred to as a marker for the proliferation rate of the cells. This means it can help determine how quickly the cells are growing. The higher the level of Ki67, the faster the cells are growing and dividing. The percentage refers to the how many breast cancer cells tested positive for Ki67. Usually less than 10% is considered low, 10-20% is moderate and more than 20% is considered high.

ER, PR and HER2 refer to receptors that are found on the breast cancer cells. Various kinds of receptors are found on the surface of all our cells, and they basically tell the cell what to do.  ER and PR are hormone receptors. ER refers to oestrogen receptors, PR refers to progesterone receptors. HER2 refers to a growth receptor called human epidermal growth factor receptor 2.

All our cells have these receptors, but breast cancer cells can have far more of these receptors. This is called having an overexpression of the receptors. When this happens, having more receptors can drive the cancer cells to continue to grow and divide. An increase in hormone receptors are commonly found in breast cancer cells. This is referred to as hormone positive breast cancer. It means that the hormones oestrogen and progesterone fuel the cancer cells to grow and divide.

How sensitive the breast cancer cells are to oestrogen and progesterone is scored out of 8. ER8 means a score of 8 out of 8 meaning the breast cancer cells are fully sensitive to oestrogen. The same applies to the progesterone score. These markers are checked to see if hormone treatment after surgery would be beneficial.

HER2 is another receptor that can fuel the cancer cells to grow and develop. This is not as commonly overexpressed as the hormone receptors are, but it is always checked for. Being HER2 positive means the cancer cells have the potential to grow and divide more quickly, there are also specific treatments that can be given to block HER2 receptors. Your result of HER2 0 means you do not have on overexpression of HER2, so you are HER2 negative.

Breast cancer now has a helpful guide to understanding your pathology results but again if it would help to chat this through with us or if you have any further questions please don’t hesitate to contact us. I hope this is helpful.

All the best,

Lynsay

Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

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