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Trucut biopsy showed infiltrating duct carcinoma. What are the complication?

Sep 2012
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General & Family Physician
Practicing since : 2008
Answered : 1416 Questions
My wife trucut biopsy right breast lump report says histological features of infiltrating duct carcinoma, Grade -2, modified BR score :6(2*2*2), there is a marked desmoplasia and mild lymphocytic infiltration.And no evidence of perineural or lymphovascular invasion.

How serious is this ant the line of treatement required now.

Sat, 5 Jan 2013 in Breast Cancer
Answered by Dr. Das Arindam 2 hours later
Thank you for posting a question.

Firstly, now a days, breast cancer becomes an epidemic like.

Now, from the report, your clinical examination revealed signs indicating more towards a malignant lesion.

The trucut biopsy specimen was adequate. Now, BR grade 2 means a moderate differentiation. That means, one malignant lesion is classifiable in 3 grades. Well differentiated, moderately differentiated and poorly differentiated. In case of breast carcinoma, well differentiated = grade 1. Moderately differentiated = grade 2. Poorly differentiated = grade 3. Here, grade 1 stands for good prognosis, grade 2 stands for moderate prognosis, and grade 3 is associated with worst prognosis.

From the discussion, it is clear that here the prognosis is variable. It will depend upon the expression of ER / PR / Her2Neu. If these are expressed by the cells then it indicates a good response to the chemotherapy. And obviously, here, the prognosis is good.

Treatment is surgical removal of the mass and followed by chemotherapy. Now, extent of surgery should be determined on the clinical evaluation, lymph node status. After the excision, the specimen should be sent for histopathological examination and also for immunohistochemistry. You can also consult with your treating doctor for sending the trucut biopsy slide for IHC. It will detect presence of ER / PR / Her2Neu. It will be helpful to determine the chemotherapeutic agents early.

Lastly, the report indicates moderately sever malignancy. Which has variable prognosis. Consult with your treating doctor about the points I have already mentioned.

Hope this information suffices. Let me know, if you have any more question.

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