Right after the tissue sample is removed, it is sent to the lab, where a pathologist looks at it. (A pathologist is a medical doctor who is specially trained to look at cells under a microscope and identify diseases.)
If the biopsy result is negative
If your biopsy result comes back negative (benign), it means that no cancer was found. If you have any questions or you feel unsure about the results of the biopsy, you might want to get a second opinion or pathology review. (A pathology review is having another doctor look at your biopsy tissue.) Once you feel comfortable that you do not have cancer, be sure to:
- Have regular mammograms (See "Appendix B" for our guidelines for finding breast cancer early.)
- Continue seeing your health care professional for routine breast exams
- Be aware of any changes in your breasts, and report changes to your doctor right away
- Talk with your doctor about your risk of breast cancer
A mammogram may show a lump or other change that can't be felt on a physical exam. Physical exams may find a lump or skin change that a mammogram doesn't show. If you ever notice a change in your breasts yourself, let your doctor know right away. Breast changes do not always mean breast cancer. (See "Appendix B" for more information on finding cancer early.)
If the biopsy shows breast cancer
If the biopsy shows that the lump is cancer, the results will tell your doctor some important things about the cancer.
Is it in situ or invasive?
The biopsy report may say that the cancer is in situ. This means that the cancer started in a lobule (milk gland) or duct (tube that carries milk from the lobule to the nipple) and has not spread to the nearby breast tissue or to other organs in the body.
Invasive or infiltrating cancer means that the tumor started in a lobule or a duct and has spread into nearby breast tissue. This type may spread to the lymph nodes or to other parts of the body through the lymph system and bloodstream.
How fast is it likely to grow and spread?
Pathologists use the microscope to look at the cancer cells and see what they look like and how they are arranged. This helps them figure out the cancer's grade. The grade tells how slowly or quickly the cancer is likely to grow and spread.
Pathologists may also use measures called ploidy, cell proliferation rate, or Ki-67 tests to give the medical team a better idea of how quickly or slowly the cancer is likely to grow and spread. These tests help your doctor to choose the best treatment.
Is the cancer HER2-positive?
Tumors with increased levels of the protein called HER2/neu are called HER2-positive. These cancers tend to grow and spread faster than other breast cancers.
HER2/neu testing should be done on all newly diagnosed breast cancers. HER2-positive cancers can be treated with drugs that target the HER2/neu protein.
Will it respond to hormone therapy?
Estrogen and progesterone receptors recognize and respond to the female hormones estrogen and progesterone. Some breast cancers have these receptors (receptor-positive), and others do not (receptor-negative). Finding out if a cancer has these receptors will help your doctor decide how likely it is that you will benefit from a hormone therapy.
Questions to ask about your biopsy results
After your biopsy results are back, it is important to know if the results are final, definite results, or if another biopsy is needed. Here are some questions to ask if they are the final results:
If it is not cancer...
- Do I need any follow-up?
- When should I have my next screening mammogram?
If it is cancer...
- Is the cancer in situ or invasive?
- If the cancer is in situ, is it a type of cancer that can become invasive?
- Does the cancer seem to be growing and/or spreading slowly or quickly?
- Will the cancer respond to hormone therapy?
- Do I need more tests to learn the stage of the cancer? (The stage is how widespread the cancer is at the time it is found.)
- What kind of treatment do you recommend for me, and why? Are there other options that might work?
- When will I need to start treatment?
More information on breast cancer and its treatment can be found in our document, Breast Cancer.
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