My Mammography result showed abnormalities. What is the next step?
You may require to undertake take a biopsy sample of your breast tissue as guided by your clinician.
What is a Biopsy and what will it indicate?
A breast biopsy is a test that removes tissue or sometimes fluid from the suspicious area. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can definitely determine if the suspicious area is cancerous.
The good news is that 80% of women who have a breast biopsy may not have breast cancer.
There are three types of biopsies:
- Fine-needle aspiration
- Core-needle biopsy
- Surgical biopsy
What you can know from the Biopsy Results?
Once the biopsy is complete, a pathologist examines the tissue or fluid samples under a microscope, looking for abnormal or cancerous cells. The pathology report, which can take one or two weeks to complete, is sent to the patient’s doctor. It indicates whether the suspicious area is cancerous and provides a full picture of your situation. For the patient, waiting for results can be a real challenge, but being able to make an informed decision regarding your treatment is well worth it. Your doctor will go over the report with you and, if necessary, discuss the treatment options.
If no cancer cells are found, the report will indicate that the cells in the lump are benign, meaning non-cancerous. However, some type of follow-up or treatment may still be needed, as recommended by the healthcare professional.
If cancer cells are found, the report will provide more information to help determine the next steps.
The report of biopsy sample will include tumor type and the tumor’s growth rate or grade. If cancer is found, the pathologist will also perform lab tests to look at cells for estrogen or progesterone receptors. The correct classification of the Breast Cancer type is most important because it will help the clinician to decide the right kind of approach towards management of the ailment in a big way.
That is where the role of Mammatyper becomes extremely important, because it correctly classifies the breast cancer into molecualr sub type which immensely helps the doctor to decide the treatment options.
What is mammatyper?
The MammaTyper is an in vitro (outside your body) diagnostic test used for appropriate classification of Breast Cancer as per St Gallen (world’s most renowned body on oncology) classification. The method involves quantitative detection of mRNA expression of breast cancer biomarkers like Human epidermal growth factor receptor 2 HER2 (ERBB2), estrogen receptor (ESR1), progesterone receptor (PGR), and marker of proliferation Ki-67 (MKI67) can be measured with this test.
The test result is furthermore prognostic for a patient’s risk of developing distant metastases and overall survival. This test will also help your physician to make the right choice of therapy for you.
I was diagnosed with breast cancer. Which test should I receive?
If you are diagnosed with breast cancer, your doctor may order additional lab tests to assist with prognosis. The two most common lab tests are the hormone receptor test and the HER2/neu test. Results from these tests can provide insight into which cancer treatment options may be most effective for you. IHC and Mammatyper are two tests which will help you know these.
Who needs hormone receptor testing?
Hormone receptor testing is generally recommended for patients who are diagnosed with invasive breast cancer. If your doctor orders this test, you may be asked to discontinue taking any prescribed hormones for a period of time before the breast tissue sample is obtained. Usually, the sample comes from a biopsy, but the test may also be performed on tissue removed during a mastectomy.
What does the test report suggest?
Breast cancer patients who test positive for both estrogen receptors and progesterone receptors usually have a better-than-average prognosis for survival and a complete recovery than those who have no receptors present. Also, the more receptors and the more intense their reaction, the better they respond to hormone therapy. Patients with one type of receptor but not the other may still reap benefits from this form of treatment, but likely not to the same degree. As mentioned earlier, if the cancer is both ER- and PR-negative, it probably won’t respond to hormone therapy. Typical response rates to hormone therapy are as follows:
- ER and PR positive: 75-80%
- ER positive and PR negative: 40-50%
- ER negative and PR positive: 25-30%
- ER negative and PR negative: 10% or less
Similar to the hormone receptor test, the HER2/neu test looks for a specific kind of protein that is found with certain types of cancer cells and the gene that produces it. The formal name of that gene is the human epidermal growth factor receptor 2, and it makes HER2 proteins. These proteins are receptors on breast cells.
When all three of the tests come back negative for receptors for hormones (progesterone and estrogen) and negative for HER2, triple negative breast cancer may be the diagnosis
Mammatyper test very effectively determines all the hormone receptors and HER2 as well. Other than these Mammatyper also helps in the correct estimation of KI67 which is a tumor proliferation marker.
What is KI 67? And why it is very important?
Ki67 is a special stain that gives a sense of how aggressive a tumor is. The pathologist takes the biopsy or surgical specimen, prepares it, puts it on to a glass slide, stains it for this protein, and look at it under the microscope.
Mammatyper outperforms IHC in predicting pCR (pathological complete response) in the neo-adjuvant setting which means Mammatyper identifies those patients who are likely to benefit from Taxane based neoadjuvant chemotherapy based on accurate determination of KI67.
Accurate determination of KI67 helps the doctor to choose the right kind of chemotherapy, that is why it is very important.
Is MammaTyper the right test for me?
Yes, because it allows a precise and accurate classification of your tumor providing your physician with reliable prognosis and guidance for optimal therapy support. Additionally, the result can be used as basis for a decision if additional tests e.g. for risk assessment are necessary.
What is OncotypeDx test? Is it same as Mammatyper?
Oncotype Dx determines the risk of recurrence of breast cancer.
No, both are not same. MammaTyper determines the subtype(classification) of breast cancer which is assigned by guidelines (St. Gallen) to treatment recommendations. A doctor will prescribe Mammatyper first because it will guide him/her to start the correct treatment.
Later on if the doctor feels right he/she may prescribe Oncotype Dx to determine the risk of recurrence of breast cancer.
What is the Price for MammaTyper test?
In India we are launching this test at a discounted price of 48500 INR for the benefit of the patients.
Is MammaTyper an approved test?
Yes it is. MammaTyper is a CE/IVD marked test in Europe and in India it is offered only at Metropolis as a laboratory implemented test.
Clinical value has been validated in numerous clinical studies across the globe.
Where can I order MammaTyper and which sample is needed?
Only FFPE tissue material is needed, which is obtained during routine cancer diagnostics (core needle biopsy) or surgery (resection specimen), no additional material is necessary.
Where can I get the test done?
Your gynecologist/pathologist can send your sample to Metropolis Healthcare
You can call 022-33993939 and directly give your pre-prepared blocks to Metropolis.
Can I give the samples in any hospital?
Yes. The sample can be given to any hospital which has an Oncology department. Then the sample will be sent to Metropolis by the hospital for testing.
What is the procedure to get the test done and my sample taken?
Your Gynecologist/Oncologist will guide you through this process
If some members in my family had breast cancer before , do I run the risk of getting the same?
Yes . Beacuse of the mutation of two genes called BRCA1 and BRCA 2.
Is there any test to identify the risk?
Yes. A breast cancer (BRCA) gene test is a blood test to check for changes (mutations) in genes called BRCA1 and BRCA2. This test can help you know your chance of getting breast cancer and ovarian cancer. And both men and women with these changes may be at higher risk for other cancers