Your Wife's Early-Stage Breast Cancer Biopsy Results

Inquire about the breast cancer tumor biopsy report issues?

Hello Dr.
Hu, my wife recently underwent a health check at her company, and an abnormality was found in her breast.
A biopsy confirmed it to be stage I breast cancer, with the tumor size estimated at about 0.7 cm based on imaging.
Since her mammogram two years ago was normal, and last year a 0.7 cm tumor was discovered, the biopsy report shows a Ki-67 index of 60%.
I found online that tumors typically take about ten years to grow to 1 cm, so I am wondering if this indicates an abnormal growth rate.
The tumor is located near the lymph nodes on the side, and the attending physician mentioned that it is relatively easy to observe, which raises some concerns.
Other data shows ER/PR (+/+), HER-2 (-).
I would appreciate your clarification, thank you!

Mr. Li, 40~49 year old female. Ask Date: 2023/01/12

Dr. Hu Ziren reply Oncology

A Ki-67 index of 60% indicates that the tumor proliferation rate is very high, suggesting that it could have grown from 0.7 cm last year to 0.9 cm this year.
A Ki-67 level greater than 20% typically signifies poorly differentiated cancer, which is associated with a rapid doubling time, a higher likelihood of recurrence, and early lymphatic metastasis.
It is advisable to discuss with your physician whether prompt surgical intervention is necessary.

Reply Date: 2023/01/12

More Info

Dear [Name],
Thank you for reaching out with your concerns regarding your wife's recent breast cancer diagnosis. I understand that receiving such news can be overwhelming, and it's important to clarify the details of her condition and what they mean for her treatment and prognosis.

From your description, your wife has been diagnosed with early-stage breast cancer (Stage I), with a tumor size of approximately 0.7 cm. The Ki-67 index, which measures the proliferation rate of cancer cells, is reported at 60%. This is considered relatively high, indicating that the tumor cells are dividing more rapidly than those in tumors with lower Ki-67 levels. While it is true that many tumors take years to grow to a certain size, the growth rate can vary significantly depending on several factors, including the tumor's biological characteristics and the individual’s unique physiology.

The fact that the tumor is located near the lymph nodes is indeed a point of concern, as breast cancers can metastasize (spread) to nearby lymph nodes. However, since your wife's cancer is classified as Stage I, it is still considered localized, and the prognosis is generally favorable at this stage. The ER (estrogen receptor) and PR (progesterone receptor) positivity indicates that her cancer is likely to respond well to hormone therapy, which can be an effective treatment option. The HER2 negativity suggests that her cancer is not driven by the HER2 protein, which is another factor that can influence treatment decisions.

Regarding your concern about the growth rate of the tumor, while a Ki-67 of 60% does suggest a more aggressive tumor, it does not necessarily mean that the cancer will behave in a way that is significantly different from other early-stage cancers. Each case is unique, and many factors, including the tumor's hormone receptor status and the patient's overall health, play a crucial role in determining the best course of action.

In terms of monitoring and follow-up, it is essential for your wife to have regular check-ups with her oncologist. This typically includes imaging studies and physical examinations to monitor for any changes. The frequency of these visits will depend on her treatment plan and how she responds to therapy.
It is also important to maintain open communication with her healthcare team. They can provide personalized advice based on her specific situation and help address any concerns you may have about her treatment and prognosis.
In summary, while the Ki-67 index is a significant factor to consider, it is just one piece of the puzzle. With appropriate treatment, including possible surgery, hormone therapy, and regular monitoring, many patients with early-stage breast cancer go on to have successful outcomes. Encourage your wife to stay positive and engaged in her treatment plan, and ensure that both of you are well-informed about her condition and the steps ahead.

If you have any further questions or concerns, please feel free to reach out. Wishing you and your wife all the best during this challenging time.

Sincerely,
Doctor Q&A Teams

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