诊断为三阴，腋下淋巴感染一个，三期，治疗方案先新辅助化疗，然后手术。保乳手术。 术后大病理检查报告，是不是预后不怎么样？为啥没看到MP分级的分数，美国的病理报告不写出来？我也没看出来是否清扫淋巴了。

Source of Specimen

A Lumpectomy 10:00 Left Breast

B Left Nonsentinel Lymph Node #1

C Left Sentinel Lymph Node #1

D Left Nonsentinel Lymph Node #2

E Inferior Deep Lateral Margin, Left Breast

Final Diagnosis

A. BREAST, LEFT, 10 O''CLOCK (LUMPECTOMY): - RESIDUAL INVASIVE DUCTAL CARCINOMA, NOTTINGHAM GRADE 2 OF 3, MULTIFOCALLY INVOLVING A 1.5 CM TUMOR BED (LARGEST CONTIGUOUS FOCUS OF INVASIVE CARCINOMA IS 1.3 CM), WITH TREATMENT RESPONSE/EFFECT. MARGINS NEGATIVE FOR INVASIVE CARCINOMA - INVASIVE CARCINOMA EXTENDS TO 1.5 MM FROM THE INFERIOR MARGIN (SEE PART E FOR FINAL INFERIOR MARGIN). SEE COMMENT AND SYNOPTIC REPORT.

- DUCTAL CARCINOMA IN SITU (DCIS), HIGH AND LOW NUCLEAR GRADE, SOLID AND CRIBRIFORM PATTERNS WITH CENTRAL NECROSIS AND INVOLVEMENT OF SCLEROSING ADENOSIS. DCIS IS PRESENT 0.5 MM FROM THE SUPERIOR MARGIN, 1.5 MM FROM THE MEDIAL MARGIN, AND 1 MM FROM THE INFERIOR MARGIN (SEE PART E FOR FINAL INFERIOR MARGIN). SEE COMMENT.

- SCLEROSING ADENOSIS, COLUMNAR CELL CHANGE, USUAL DUCTAL HYPERPLASIA, FIBROADENOMATOUS CHANGE, DUCT ECTASIA, CALCIFICATIONS, AND BIOPSY SITE CHANGES

- BENIGN SKIN

B. LEFT NON-SENTINEL LYMPH NODE #1: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1)

- FIBROADIPOSE TISSUE WITH FOCAL FAT NECROSIS, FIBROSIS, HEMOSIDERIN DEPOSITION, AND MULTINUCLEATED GIANT CELL REACTION

C. LEFT SENTINEL LYMPH NODE #1: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1)

D. LEFT NON-SENTINEL LYMPH NODE #2:

- TWO LYMPH NODES, NEGATIVE FOR CARCINOMA (0/2)

E. BREAST, LEFT, INFERIOR DEEP LATERAL MARGIN: - FOCAL DUCTAL CARCINOMA IN SITU (DCIS), HIGH NUCLEAR GRADE, SOLID PATTERN. DCIS IS PRESENT LESS THAN 0.5 MM FROM THE NEW INFERIOR MARGIN. SEE COMMENT.

- SCLEROSING ADENOSIS, USUAL DUCTAL HYPERPLASIA, COLUMNAR CELL CHANGE, APOCRINE METAPLASIA, FOCAL DUCT ECTASIA, AND CALCIFICATIONS

Comment

DCIS is seen in multiple blocks (10 out of 20 blocks of breast tissue evaluated) in association with and away from the biopsy site. It is present as high-grade DCIS with central necrosis and also as separate, distinct foci of low-grade DCIS involving sclerosing adenosis. The invasive carcinoma shows some features suggestive of partial squamous differentiation. Immunostains for p63, smooth muscle myosin heavy chain, and e-cadherin are evaluated and support the diagnosis. Receptor studies have been repeated on the current specimen and results are as follows

Breast Biomarker Checklist Release Date: 2/28/2020

TEST(S) PERFORMED TEST(s) PERFORMED: Estrogen Receptor (ER) Status, Progesterone Receptor (PgR) Status, HER2 by Immunohistochemistry, Ki-67

ESTROGEN RECEPTOR (ER) STATUS: Negative (less than 1%) - Internal control cells present and stain as expected

TEST TYPE: Laboratory-developed test

PRIMARY ANTIBODY: 6F11

PROGESTERONE RECEPTOR (PgR) STATUS: Negative (less than 1%) - Internal control cells present and stain as expected

TEST TYPE: Laboratory-developed test

PRIMARY ANTIBODY: 1294

HER2 BY IMMUNOHISTOCHEMISTRY: Positive (Score 3+)

PERCENTAGE OF CELLS WITH UNIFORM INTENSE COMPLETE MEMBRANE STAINING: >10% 

TEST TYPE: Food and Drug Administration (FDA) cleared (test / vendor): Roche

PRIMARY ANTIBODY: 4B5

PERCENTAGE OF CELLS WITH NUCLEAR POSITIVITY: Approximately 5-10% COLD ISCHEMIA AND FIXATION TIMES: Meet requirements specified in latest version of the ASCO / CAP Guidelines

Synoptic Data

BREAST Invasive Carcinoma, Resection Checklist Release Date: 2/28/2020

SPECIAL STUDIES

BREAST BIOMARKER TESTING PERFORMED ON PREVIOUS BIOPSY: Estrogen Receptor (ER), Progesterone Receptor (PgR), HER2 (by immunohistochemistry)

ESTROGEN RECEPTOR (ER) STATUS: Negative

PROGESTERONE RECEPTOR (PgR) STATUS: Negative

HER2 (by immunohistochemistry): Negative (Score 1+) TESTING PERFORMED ON CASE NUMBER: ST-21-2757

COMMENT(s): Receptor studies have been repeated on the current specimen and results are reported in the Comment section