Following is a list of questions you need to ask and a review of what the answers indicate.
About the Chem Screen (SMAC)
Are my liver and bone enzymes normal?
An answer of “yes” combined with no symptoms of liver or bone disease suggests that cancer has not spread to those organs. It also means that it’s probably pointless to do bone or liver scans. An answer of “no” requires immediate attention and perhaps scans.
About the CBC (Complete Blood Count)
Is my CBC normal?
An answer of “yes” merely confirms that you don’t have the anemia of late-stage cancer. An answer of “you’re anemic” usually just means iron deficiency, but have your doctor follow up with specific iron-deficiency tests.
About the Chest X Ray
Is my chest X ray normal?
An answer of “yes” suggests that cancer has not spread to the lungs. Confirmed evidence of spread to the lungs means late-stage disease.
when the pathology report becomes available to your doctor, you will be told if you have cancer. If you do, there are many relevant questions you should ask to help you determine your treatment plan.
How large was the cancer?
Make sure the doctor distinguishes your question from “how large was the tissue that was cut out?”
What kind of breast cancer is it?
“Infiltrating ductal” or “infiltrating lobular” are the two most common answers. If the reply is anything except these two, it’s possible that your prognosis is exception ally good.
What grade is the cancer?
“Very well differentiated” or “highly differentiated” (also sometimes called “grade 1”) is a good sign. “Moderately differentiated” (“grade 2”) is not a bad sign. “Poorly differentiated” increases the likelihood that chemotherapy or ovarian ablation should be seriously considered.
Is my estrogen receptor status considered positive?
In general, an answer of “yes” is thought to improve prognosis somewhat. More specifically, if you are postmenopausal and your status is positive, the drug that you will probably be offered, tamoxifen, is more likely to help fight the cancer.
What is my specific estrogen receptor level?
For premenopausal women, the specific ER level may determine whether surgical removal of the ovaries might be more effective than chemotherapy. Such an approach may have fewer side effects.
Do I have diploidy?
An answer of “yes” is considered a good sign, but the importance of this test is still in debate.
Is my S-phase fraction relatively low?
An answer of “yes” means that the cancer cells were reproducing slowlyÑa good sign. Again, this test’s importance is still unclear.