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Pathology Report


66/F Laboratory Results

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Patient:
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From Date: 020304

To Date: 020304
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Personal Physician:
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............Procedure................ Results................ (Reference Range)..........
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SP Final Report ..
Specimen

Left breast core biopsy, 1200

Breast, needle localization biopsy.
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Diagnosis

Infiltrating carcinoma, left breast mass needle biopsy at 12 o'clock.

020305 /jkb

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The specimen is sent for ERA, PRA, HER-2/neu, and DNA studies.

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The diagnosis was voicmailed to Nurse Practitioner Greenberg on

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020305 at 1030
ERA/PRA/HER2/NEU
Ordered: 020305........................ Status: Ordered
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CLIN HISTORY

Resources ID:


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History

Left breast mass at 1200. 3x4 CM non-mobile (highly suspicious for cancer) with 2.5 CM axillary adenopathy.

Exogeneous Hormones: DC'D LMP: 20 years
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Gross Desc

Received are three core biopsies of yellow-white fibrofatty tissue measuring 1, 1 and 1.1 in length x 0.1 cm in diameter.

The diagnosis was voicmailed to Nurse Practitioner on 020304 1604
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All. 1. (cb) LKF/prv


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SP Final Report

Specimen

Lt breast for ERA/PRA/HER2NEU
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IHC/ERA/PRA/HER2NEU
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Diagnosis

Immunohistochemistry
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Left breast (WS02-5241):
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Immunohistochemistry Analysis:

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Estrogen Receptor: ...............( )...Positive

..............................................(X)...Negative

No staining of infiltrating tumor cells with estrogen receptor specific antibody.
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Progesterone Receptor: ...........( )...Positive

................................................(X)...Negative

No staining of infiltrating tumor cells with progesterone receptor specific antibody.
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HER2/NEU: ...........................( )...Positive

................................................(X)...Negative

No specific surface membrane staining of infiltrating tumor cells seen with the HER2/NEU antibody.
(bk/08)


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Kaiser Permanente - Confidential Patient Information




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Page 2

66/F Laboratory Results

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............Procedure................ Results................ (Reference Range)..........
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COMMENT:
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Interpretation of results

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Estrogen and Progesterone Immunohistochemical Receptor Analysis
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Tumors with less than 5% of nuclear staining are considered to be negative for the respective anitbody.



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Her2/neu Immunohistochemical Receptor Analysis

0, negative

No staining at all or membrane staining in less than 10% of the tumor cells is observed


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1+, negative

A faint/barely perceptible membrane staining is detected in more than 10% of the tumor cells. The cells only stained in part of their membrane.
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2+, weakly positive

A weak to moderate staining of the entire membrane is observed in more than 10% of the tumor cells
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3+, strongly positive

A strong staining of the entire membrane is observed in more than 10% of the tumor cells
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====== PLEASE NOTE ======


The immunoperoxidase panel reported above was developed and its performance characteristics determined by the Regional Immunohistochemistry Laboratory/The Permanente Medical Group, Inc., Northern California. It has not been cleared or approved by the U.S. Food and Drug Administration, although such approval is not required for analyte-specific reagents of this type.

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CLIN HISTORY

Resources ID:


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HISTORY

{None Given}


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IMAGE ANALYSIS

HISTORY:
SOURCE.............................. L. BREAST
SPECIMEN TYPE............... FIXED
TESTS REQUESTED.......... DNA PLOIDY; PROLIFERATION
SURGICAL NUMBER:
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DR PHONE/FAX
DIAGNOSIS
ICD9 CODE
OTHER COMMENTS
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DNA ANALYSIS

DNA Analysis
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METHOD (IMAGE-TISSUE)

DNA Ploidy

DNA ANEUPLOID
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DNA INDEX

1.6
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MIB1

16%................ BORDERLINE

MIB1 RANGES
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Low: 0...................... 14%





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Page 3

............Procedure................ Results................ (Reference Range)..........
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Borderline: .............. 15 - 31 %

High: .................... 32 - 100 %
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COMMENT-

Please note that proliferation analysis performed on a small needle biopsy, as in this dcase, can be artifactually low, due to sampling error. The area assesed should reflect the area of highest proliferation, which is generally around the tunor's perimeter.
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DATE: 020312

MIB-1 is determined by immunohistochemical methodology. This test was developed and its performance characteristics determined and deemed acceptable by Kaiser Permanente Regional Laboratory. It has not been cleared or approved by the U.S. Food and Drug Administration.
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=== End of Report ===