Borderline pathology of a core needle biopsy for breast cancer seems to mean that its in a grey zone between benign diagnosis and a cancer diagnoses.

In an issue of the British Journal of Cancer it states that one-third of breast core needle biopsy (CNB) specimens with borderline pathology prove to be malignant.

Dr. Nehmat Houssami and Dr. Stefano said in an interview with Reuters Health "We want physicians to keep in mind that a CNB diagnosis of a borderline lesion is not 'negative' for cancer, and on the contrary, it is flagged that further management/treatment step is needed."

The article also states that the information to the patient should be balanced. Yes, this could be breast cancer but to reassure a bit ( I don't know if this would actually make me less anxious) but approximately one in three will actually be malignant and the other two will prove to be benign.

Take home message: Read you pathology report, get help understanding your pathology reports and make sure if the results need to be investigated further that you push for it.

And oh yes, I have been in that wonderful position pictured -- wasn't all that bad. That time it came back benign!

I never got a chance to call for the results of my breast biopsy the day after it was performed -- because my phone rang hours before I was told to inquire about the pathology of my lump. That one phone call changed everything. Forever.

November 2004

The next day, November 24 and the day before Thanksgiving, my phone rang at 10:00 AM and the doctor who did the biopsy said the pathology report was back already. He said that unfortunately, cancer cells were found. He said I would need a lumpectomy (surgery to remove the lump), radiation, and possibly chemotherapy. He told me to buy a book called Dr. Susan Love's Breast Book. I got the book that day.

Somehow, I made it though the Thanksgiving weekend, with my thoughts jumping from the hope that this would turn out okay to the fear that I would not see my boys grow up. My mind wandered and worried about surgery and what treatments I would have. I wondered if I could have more kids and whether or not I would lose my hair. I cried and lost sleep and was hopeful too.

I learned a lot from reading my new book. I learned that many women do go on to have kids after cancer but I also learned that chemotherapy in young women can cause early menopause. I learned that I have an 85 percent survival rate and also that I will get tiny little tattoos surrounding my breast to aid in the proper delivery of radiation. These permanent tattoos will also alert any future doctors that my breast has had radiation because I can never have it again in that same area. The book helped me feel positive about this journey but it also helped me face reality.

I have since faced reality. And now I am surviving the reality of breast cancer. Following my diagnosis, I endured a lumpectomy, four rounds of dose-dense chemotherapy, more than six weeks of radiation, and one year of Herceptin treatment. Through it all, I learned that I am okay, that I will likely see my boys grow up, that my early menopause was only temporary, that I am physically able to have more children, that I did in fact lose my hair, that my 10 tiny tattoos are so small I can barely see them, that my survival rate is much higher than 85 percent.

I think I was the only one who truly believed the lump in my breast was cancer. No one else -- my mom, my sister, my husband, my doctors -- believed I was a candidate for this disease. I was young, had no family history, had no known risk factors. It just wasn't likely, even after an ultrasound revealed something suspicious.

The surgeon who performed my biopsy was in the same camp. It was probably nothing.

November 2004

On November 23, I had a biopsy. A large needle was placed in my breast and a piece of the lump was pulled out. The doctor had a hard time getting a piece, however, because it moved around so much. He said this was a good sign -- the movement. He sent the tissue to pathology and told me to call his office the next afternoon for the results.

My breast cancer friend Adriene -- who I wrote about on May 19 -- e-mailed me today about a friend of a friend who was just diagnosed with breast cancer. This friend -- Jen -- is 31 years old and just yesterday had a lumpectomy. Adriene asked if I could be in touch with Jen since, like her, I am young and I am a breast cancer survivor and I had a lumpectomy. So far, we are somewhat alike. And depending on the results of Jen's pathology report, we may be even more alike -- if she follows a path anything like mine that included chemotherapy and radiation therapy and Herceptin therapy -- or our paths might diverge from one another. Regardless, I feel a connection to this woman, much like I do with anyone with cancer whose path I cross, anyone who is sent my way, anyone who finds me for the sole purpose of support.

So I told Adriene in my return e-mail, "Yes, I will contact Jen." And I have already sent her an e-mail. And I hope when she reads it that she finds a trace of comfort, a hint of encouragement, a glimpse of hope that can somehow transform scared souls into confident spirits. I hope that she emerges from under the rock of breast cancer. Like I did. Like Adriene did.

After I was diagnosed with Stage IIa breast cancer one of the things I did was go crazy with searching, searching and more searching on the internet. What was I searching for? I'll tell you. I was searching for some prognostic information that said that I was definitely going to survive. Guess what? I didn't find what I was searching for.

Some prognostic information for my stage of disease sounded great to me, other things I read were not so great. So what did I do? I printed out the ones that sounded great, of course.

I did find in my searching a prognostic indicator that I was not aware of -- one that wasn't mentioned by my oncologist. The prognostic indicator I found is called the Nottingham Prognostic Index (NPI). NPI has been around since 1992. It can give physicians a guide to see if chemotherapy is warranted just like how the staging system is used. This prognostic indicator takes into consideration the size of the tumor, the nodal status and also the grade of the tumor. This information is plugged into a calculation using all three factors.