Breast Center

Breast imaging biopsy and pathology results

Getting Your Breast Biopsy Results

Your results will be available to you and your doctor within 3-6 business days. Results will be in your medical record, sent to your doctor, and available for you in MyChart on the day the pathologist completes the report. A member of the Breast Center team will contact you within 1-2 business days (8am-5pm; not weekends or holidays) of your results becoming available. They will explain your biopsy results. They will discuss if and when any more tests or referrals to a Breast Center provider are needed.

Second Review (Radiologic-Pathologic Correlation)

The pathology result may not be the only factor determining what should be done after your breast biopsy. An important next step is a second review called "radiologic-pathologic correlation." During this, the radiologists (breast imaging doctors) look at your breast X-rays and discuss results with the pathologists (tissue examination doctors) as necessary to make sure that they make sense together. This step ensures that we provide you with the best recommendation for your care.

In many cases a Breast Center team member will discuss with you the results of this second review at the same time that they discuss your pathology results (within 1-2 business days). However, the correlation process may take a few extra days (up to a week) if further review is required to make a final decision. Results are described this way:

  • Concordant: if the radiology images and pathology results match

  • Discordant: if the radiology images and pathology results do not match

  • Insufficient: if extra tissue is needed to make a final decision

Understanding Your Pathology Results

Breast pathology results often contain words that are unfamiliar. Your health care provider or a Breast Center team member will explain the results and help you with the next steps in your care.

For a "benign" or normal result, no more appointments or X-rays may be needed. For a result that is cancer, pre-cancer, or indicates an increased risk of cancer, you will be scheduled to meet with a Breast Center provider. A Breast Center team member will talk with you by phone before this appointment.

The list below provides brief descriptions of some words used in pathology reports. A member of the Breast Center team will review this when they call you.

Precancerous and Cancerous Results

Ductal Carcinoma in Situ (DCIS)

  • Cancer cells are present inside the milk ducts of the breast but have not spread into other breast tissue on this biopsy. This is Stage 0 cancer, sometimes called "pre-cancer." There are other conditions that are very similar to DCIS, but with different names, including Encapsulated Papillary Carcinoma and Solid Papillary Carcinoma. Some types of Lobular Carcinoma in Situ, including one called Lobular Carcinoma in Situ, Pleomorphic Type, are also considered similar to DCIS. These are less common forms of "pre-cancer."

  • We suggest that you meet with a breast surgeon to discuss treatment options. Treatment options are based on your health and personal preferences.

Invasive Carcinoma

  • Cancer that has spread (or "invaded") into the breast tissue outside of the milk ducts. Invasive carcinoma is also called "infiltrating" carcinoma.

  • There are many types of invasive carcinoma. The most common are invasive ductal carcinoma and invasive lobular carcinoma. Other less common types are tubular carcinoma, mucinous carcinoma, medullary carcinoma, micropapillary carcinoma, metaplastic carcinoma, and adenoid cystic carcinoma. The word "invasive" may not be included in the diagnosis for these less common subtypes.

  • The words "invasive" or "infiltrating" do not mean the cancer has spread beyond your breast, but this type of cancer can spread beyond the breast. Your doctor will talk about treatment options at your appointment and staging of your breast cancer at your appointment.

Grade and Stage of Breast Cancer

  • Grade: Describes how the cells look under the microscope and how different the cells are from normal breast tissue cells.

  • Stage: There are two types of staging:

    • The clinical stage describes your cancer before surgery and can include information from the pathology report of your biopsy as well as your X-rays and physical examination by a provider.

    • The pathologic stage describes your cancer after it has been surgically removed and evaluated by a pathologist.

  • Your doctor will discuss each of these in more detail at your appointment.

Receptors or Biomarkers

There are several "receptors" or "biomarkers" that may be present in breast cancer. Testing for these can help assess risk and guide treatment. The three main receptors/biomarkers are Estrogen Receptor (ER), Progesterone Receptor (PR or PgR) and HER-2/neu (also written as HER2).  Invasive cancers are tested for all three of these, but Ductal Carcinoma in Situ (DCIS) may only be tested for Estrogen and Progesterone Receptors. The results of biomarker testing may appear on your pathology report. Your Breast Team provider will explain this in detail at your appointment.

Results Indicating Increased Risk of Cancer

These results are not cancer or pre-cancer, but they indicate a higher-than-average risk of developing breast cancer in the future.

Atypical Ductal Hyperplasia (ADH)

  • Describes small groups of abnormal cells in the milk ducts of the breast. This is not a cancer but may or may not progress to pre-cancer or even invasive cancer. The presence of this condition means that you are at a higher-than-average risk to develop breast cancer.

  • We suggest that you meet with a surgeon to discuss treatment options. Surgery to remove this area along with more frequent breast imaging may or may not be recommended.

  • The surgeon will discuss the best treatment for you based on your family history, health, lifestyle and personal preferences.

Flat Epithelial Atypia (FEA)

  • Describes groups of abnormal cells in the milk ducts of the breast. These cells are usually "less abnormal" than the cells in Atypical Ductal Hyperplasia. The presence of Flat Epithelial Atypia means that you are at a slightly higher-than-average risk to develop breast cancer.

  • We suggest that you meet with a surgeon to discuss treatment options, which may include follow-up mammograms.

Lobular Carcinoma in Situ, Classical Type (LCIS)

  • This term is confusing because it includes the word "carcinoma," but it is NOT breast cancer or pre-cancer. Lobular Carcinoma in Situ, Classical Type describes certain abnormal cells present in the lobules of the breast.  This condition puts you at a slightly higher-than-average risk to develop breast cancer in the future.

  • This condition is not easy to see on mammograms. It is most often discovered as a result of a breast biopsy done for another reason.

  • We suggest that you meet with a surgeon to discuss treatment options. Surgery to remove this area along with more frequent breast imaging may or may not be recommended. The surgeon will discuss the best treatment for you based on your family history, health, lifestyle and personal preferences.

  • Some other types of Lobular Carcinoma in Situ other than "Classical Type" may behave more like Ductal Carcinoma in Situ (see above explanation of Ductal Carcinoma in Situ).

Atypical Lobular Hyperplasia (ALH)

  • Describes certain abnormal cells present in the lobules of the breast of the breast. This condition puts you at a slightly higher-than-average risk to develop breast cancer in the future.

  • This condition is not easy to see on mammograms. It is most often discovered as a result of a breast biopsy done for another reason.

  • We suggest that you meet with a surgeon to discuss treatment options. Surgery to remove this area along with more frequent breast imaging may or may not be recommended. The surgeon will discuss the best treatment for you based on your family history, health, lifestyle and personal preferences.

Phyllodes Tumor

  • A collection of altered tissue within the breast, made up of ducts and lobules (the milk-producing part of the breast) as well as connective tissue (the tissue that holds the ducts and lobules together). Phyllodes Tumors are usually benign (not cancer) but may grow relatively large and may grow back after removal.  On a rare occasion, a Phyllodes Tumor may be malignant (cancer).

  • Phyllodes Tumors require surgery to completely remove them and to prevent re-growth.

  • These tumors can grow quickly causing a lump you can feel or see.

  • We suggest that you meet with a surgeon to discuss these findings in more detail.

Radial Scar or Complex Sclerosing Lesion

  • These are benign (not cancer) conditions, but they may appear similar to breast cancer on mammogram or ultrasound. Being diagnosed with one of these conditions may mean that you are at a slightly higher-than-average risk to develop breast cancer in the future.

  • Often, we will recommend an appointment with a surgeon to discuss results and treatment options. In some cases, we recommend follow-up breast imaging.

Benign (Not Cancer) Results 

Intraductal Papilloma

  • An intraductal papilloma is a lump that develops in one or more of the milk ducts of the breast. Often, we recommend only routine follow-up imaging after a biopsy shows a papilloma.

  • We will arrange an appointment with a Breast Center surgeon to discuss your treatment options if you have any other findings or symptoms:

    • Atypical cells (abnormal but not cancer) within the papilloma

    • Multiple intraductal papillomas

    • Nipple discharge or other symptoms

Fibroadenoma

  • A benign (not cancer) mass of firm, rubbery tissue, made up of lobules and ducts (the milk-producing part of the breast) as well as connective tissue (the tissue that holds the ducts and lobules together). Fibroadenomas are very common. These masses do not increase your risk of breast cancer

  • If a fibroadenoma is large (more than 2 inches), begins to grow, or is causing pain, you may want, or be advised to have it removed. If any of these conditions exist, an appointment with a Breast Center provider can be arranged. Otherwise, you can continue with regular breast exams or mammograms.

Sclerosing Adenosis

  • This describes a benign (not cancer) change in the shape of the milk ducts. Usually no further treatment or follow-up for this finding is needed.

Usual Ductal Hyperplasia

  • This describes benign (not cancer) cells growing in the milk ducts. Usually no further treatment or follow-up for this finding is needed.

Apocrine Metaplasia

  • This describes a benign (not cancer) change in the appearance of the milk duct cells. Usually no further treatment or follow-up for this finding is needed.

Benign Calcifications

  • Calcifications are often seen on mammograms. Many of these can be safely determined to be benign (not associated with cancer) without the need for biopsy, and some require biopsy for confirmation.

Pseudoangiomatous Stromal Hyperplasia (PASH)

  • A benign (not cancer) lesion in the breast that may or may not form a lump.

  • If a lump is present, you may be scheduled with a Breast Center provider to discuss removing it, particularly if it is growing or painful.

Fibrocystic Change

  • This is a general term that describes some combination of the benign (not cancer) findings listed above. Usually no further treatment or follow-up for this finding is needed.

Other Types of Results

There are many other possible types of pathology identified on breast biopsy.  A Breast Center team member will discuss these, as well as next steps with you when they call you with your pathology results.