In our last blog we explained what a biopsy is, the 3 different kinds of biopsy that can be performed – as well as what to expect if you are going to have one done. But what exactly will the doctor be looking for when the results come through?
From an advocacy aspect, the same diagnostic tools are used in both the Public and Private sector in South Africa – and a management decision is made by a team of specialists using all the information they can get. eg. (This will include the size of the tumour and whether it has moved into the lymph system.)
If the biopsy results show the presence of cancer, the doctor will also be able to see exactly what kind of breast cancer you have. And because there are so many different types of breast cancer, a wide variety of treatment options are available.
In terms of our goal of lobbying government to create an implement an effective and equitable BREAST HEALTH POLICY, this is an important fact to note: malaria or TB are ‘single’/simple diseases which only need one kind of treatment — thus making them more ‘affordable’ diseases for the government to manage, as opposed to the complex — and expensive — variety of breast cancer treatments!
The biopsy results help the surgeon and the oncologist to decide on the right treatment for the right patient at the right time. Tumours can be separated into 4 main types based on their ‘histological’ type (i.e. the type of tissue where the cancer originates), the grade of tumour (how fast it is growing) and whether the breast cancer cells have receptors for the hormones, oestrogen and progesterone. These hormone receptors are proteins (found in and on breast cells) which pick up hormone ‘signals’, telling the cells to grow.
Therefore, a cancer is called oestrogen-receptor-positive (ER+) if it has receptors for oestrogen. A cancer is progesterone-receptor-positive (PR+) if it has progesterone receptors. This means: cancer cells can receive signals from hormones which could make them grow faster.
***FACT: about 2 out of every 3 breast cancers test positive for hormone receptors.***
Her-2-neu Oncogene: A biopsy will also tell the doctor about the cancer’s Her-2-neu oncogene status — i.e. if there is a genetic link to the type of cancer you have. (Watch the video below for an excellent visual summary of Her-2-neu.)
Guest post by Dr Judith Whittaker, consulting pathologist.