Evaluating The Tumor - Making The Diagnosis: Breast Cancer

Content provided by the Faculty of the Harvard Medical School

Evaluating the tumor

The evaluation of the tissue removed by biopsy or surgery is a key determinant of prognosis and the breast cancer treatment your oncologist advises.

It is therefore important that the breast tissue is evaluated by a pathologist knowledgeable in the field of breast cancer. Often, a second pathological opinion may be requested by your physician, or you may request a second opinion yourself. Be assured that you will not be stepping on anyone's toes or offending anyone. This is a common practice to provide you and your oncologist with the most reliable information that will guide your care.

The pathologist performs a detailed analysis of breast cancer tissue to:

• Determine the type of cancer cells and whether the cancer is the cancer is in situ (noninvasive) or invasive.

• Determine the size of the cancer

• Determine microscopic and hormonal characteristics of the cells.

• Help predict how the cancer is likely to behave.

• Help guide the choice of therapy that is most likely to provide the desired outcome. The analysis of the cancer cells can help direct physicians to select specific treatments that have a higher probability of being effective.

• Determine whether the surgical removal of the breast lump was complete; or whether a so called re-excision (re-removal) is indicated. The pathologist can do this by evaluating the margins of the removed lump for the presence or absence of cancer cells. If removal is incomplete, re-excision and removal of additional breast tissue is indicated.

Last updated:	April 23, 2007