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Diagnosis

 
Diagnosis

Chapter: 4 - Diagnosis

Subchapter: 5 - Lab Tests

Once the biopsy is complete, a specially trained doctor called a pathologist will examine the tissue or fluid samples for abnormal or cancerous cells. Pathology reports can take one or two weeks to complete. The wait can be a real challenge, but being able to make an informed decision regarding your treatment is well worth your time. Remember, the pathology report helps give a full picture of your situation.

A core needle biopsy sample provides information on the tumor type and the tumor’s growth rate, or grade, which we discussed in Subchapter 3.2. If cancer is found, the pathologist will also test the cells for estrogen or progesterone receptors.

When a lumpectomy or wide local surgical biopsy is performed, the results provide information on the type, grade, and receptor status of the tumor. It can also can measure the distance between the surrounding normal tissue and the excised tumor. This distance, called the margin, shows whether the site is clear of cancer cells or not.

A positive margin means cancer cells are present at the margin of the tumor. A negative margin means there are no tumor cells at the margin. A close margin means that the distance between the tumor and normal surrounding tissue is less than about 3mm (.118 inch).

Using the pathology report and any additional scans or blood work, the cancer is classified into stages. Your medical team will use this information to design the best plan for you.

But before we discuss treatment options, in Chapter 6, we will elaborate on the types and stages of cancer.

Related Questions

  • Joellen Wolfson Profile

    What type of treatments are available after a lumpectomy?

    Asked by anonymous

    Learning About Breast Cancer
    almost 8 years 5 answers
    • View all 5 answers
    • Erin Timlin Profile
      anonymous
      Survivor since 2011

      Usually a lumpectomy is followed by chemo (if the tumor was large enough or there was nodal involvement) or radiation (if you didn't need chemo or did the chemo first). I don't think the lumpectomy is ever done in isolation. Something else needs to be done in conjunction.

      Comment
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      I agree with Erin. There is radiation and possibly chemotherapy, as Erin says, if there is lymph node involvement. I have never heard of just a lumpectomy.... there is just too much chance of a few cancer cells wandering around that need to be cleared up.
      Take care, Sharon

      2 comments
  • Thumb avatar default

    Had lumpectomy and reexcision two weeks ago. Breast feels a little lumpy above the excision site. Is that normal? Also still having occasional twinges of pain.

    Asked by anonymous

    Stage 2A Patient
    over 7 years 2 answers
    • Coco Smith Profile
      anonymous
      Learning About Breast Cancer

      Yes - very normal. Especially if you are in the approx 40% of women[like me] who ended up with a seroma i/under their lumpectomy surgical scar. A seroma is a fluid filled sac. It can become encapsulated ie., covered in very hard tissue which can be painful OR if can stay as it is OR as it can...

      more

      Yes - very normal. Especially if you are in the approx 40% of women[like me] who ended up with a seroma i/under their lumpectomy surgical scar. A seroma is a fluid filled sac. It can become encapsulated ie., covered in very hard tissue which can be painful OR if can stay as it is OR as it can slowly be reabsorbed by your body and disappear.

      You need to ensure the pain is not from a wound infection - is it hot, throbbing, oozing, raised body temperature or any other classic signs of infection?

      If not, high chance a seroma. Seromas normally diagnosed by ultrasound - as mine was after I continued to feel pain in/under lumpectomy scar without any sign of infection and had to ensure my breast did not jiggle as this sent shooting pains. Going over speed humps was the worst!

      If it is a seroma you also have a critical decision to make. Many resolve over time on their own or at least reduce to point where they are less painful. Others encapsulate or grow bigger.Some Drs will offer to aspirate your seroma ie., insert a needle into it and withdraw the liquid inside it, deflating it. There are negatives associated with this. Many time it is futile as it refills with liquid very quickly and the pressure and pain return. Inserting needles can introduce infection when there is none. Having more procedures on an already pummelled breast focussed on the same spot can be very upsetting as well as painful. On the positive, a percentage of seromas can be permanently deflated this way.

      The ultrasound will give you the exact dimensions if it is a seroma. That may assist you make up your mind about what to do. Mine was 4mm, it increased to 8mm and was becoming more of a daily problem, but reduced back to 4mm, which I can cope with. I notice if I am tired, run down or been doing things like lifting children or animals and they have pressed or come into contact with my affected breast, it gets more painful.

      There is the potential for the pain to be from other things eg., something left inside from the procedure, there may be stitches still inside, but that is more likely to be linked to infection. The thing about cancer spread is that is mostly painless in the earlier stages, but it has to be considered as well. The more accurate test for that is a dual breast coil MRI - MRI's are far more accurate than mammograms especially in denser breasts, unlike xrays or CT there is no large radiation dose and it is accurate down to very small cells. My imagist tells me MRI's detect cancer years years before other methods do. MRI's are noisy and you need a contrast dye for cancer cells detection.
      The problem is when your breast is still so tender from surgery and you are still in pain, the last thing you want is to have is them squished in a mammogram!
      Hope this gives you an oversight of main issues. Get it checked out!

      2 comments
    • Jk Joyce Profile
      anonymous
      Survivor since 2012

      I am the same way. The onc said it was normal and may take a year to go away. I had a lot of shooting pains today and that is normal too...although it is not fun!

      Comment
  • Thumb avatar default

    What is the prognosis of stage 3 medullary carcinoma? Ten years ago I had a lumpectomy and radiation. Now I have tumors in both breasts and face a bilateral radical mastectomy plus chemo. What is my prognosis?

    Asked by anonymous

    Learning About Breast Cancer
    almost 8 years 4 answers
    • View all 4 answers
    • Sharon Danielson Profile
      anonymous
      Survivor since 2007

      When I was going through cancer treatment, I refused to hear negative stories. It didn't do me any good and just depressed me. There are many more women alive today because of the treatments available. No human can really talk prognosis with any amount of certainty because we don't have a...

      more

      When I was going through cancer treatment, I refused to hear negative stories. It didn't do me any good and just depressed me. There are many more women alive today because of the treatments available. No human can really talk prognosis with any amount of certainty because we don't have a clue. If I were you, I would not focus on your diagnosis but on your fight that is ahead of you. Here is Marianne, who has fought a huge battle and won. There are many, many women on this board who have made it and are alive and well today. We are all here to support you. We know this is the scary thing to be facing but we have all been there. We know that terror but also know success. Please don't spend time and energy looking at that half empty glass.... you might at well believe you are going conquer this and win the battle. Do not put a limit on your life by talking prognosis because in reality, it doesn't help you.... it drags you down both mentally and physically. Who actually knows what YOUR prognosis will be?Prognosis, is a cold, analytical statistic.... you are a warm, loving, living, breathing, feeling, human being. Only God knows how long any of us have on this earth. Your job right now is to fight like a girl, get through your treatment and start living your wonderful life. Again, we are all here to support you and share our experiences with you. God's blessings to you. Hang in there and take care, Sharon

      1 comment
    • Thumb avatar default
      anonymous
      Learning About Breast Cancer

      The minute that I was diagnosed I made the decision to have a bilateral mastectomy and it was the best decision I have made. I will soon have my implant exchange.

      Comment
  • Thumb avatar default

    Why after receiving 5 mamograms on one breast I need to get an ultrasound next? What could this mean?

    Asked by anonymous

    Learning About Breast Cancer
    about 8 years 5 answers
    • View all 5 answers
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      Yes, it sounds as if your doctor is being very thorough. That's a good thing! So many things that are non cancerous can be seen such as micro calcifications, etc. Any changes in the breast need to be checked out. I firmly believe in doing self exams as well.

      Comment
    • Donna Gray Profile
      anonymous
      Survivor since 2011

      To start, having 5 mammograms before 1 ultrasound is crazy. But the reason for the ultrasound is to get a more thorough look. It doesn't necessarily mean its something bad. Stay positive!!! God Bless you.

      Comment

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