Annie wrote: <<  >><BR><BR>
<< How can a biopsy report {cytopathology report} show ER positive, and PR
"weakly positive" and then report after surgery {mast} show both these
as being negative?

Welcome to the world of medicine....
Sorry you are having to deal with this and hope it soon gets resolved but am
not at all surprised.  Over the past 30 years my job/profession includes
medical records review.  It is often the exception rather than the rule that
all records are accurate...

The biopsy deals with a tiny sample, the post-op path report deals with the
whole tumour which is not necessarily uniform.  The biopsy is really only a
rough guideline to the pathology of the tumour, it's being done to give a
yes/no answer to the question "is it malignant?" and I think one would take
any other conclusions drawn from it with a pinch of salt.

Remember that 'positive' and 'negative' each cover a wide range of values,
divided by an arbitrary line, so it is possible that there was not actually
much difference, that both were close to the borderline.

Tim

Annie wrote<< How can a biopsy report {cytopathology report} show ER positive,
and PR
"weakly positive" and then report after surgery {mast} show both these
as being negative? >>

Annie, I am guessing you never had your pathology slides re-read.  You can
still do that for both the biopsy as well as main tumor.  When we went for 2nd
opinions early on we were requested to bring the pathology slides.  Even when
all concurred, one of the top research oncologists we saw recommended we have
them re-read again by a certain pathologist (who worked at a different, rival
university) whom he told us he thought was the "best pathologist in the world."
That pathologist agreed with just about everything althoug recommended we have
the Her2 test re-done since that was done with an older type of method which
was  more open to error.  We debated since this was after I was offered
Herceptin out-of-protocol.  We did, however, run into two pathologists while at
the lab, and we asked if we could ask them a question regarding Her2 testing.
They were very familiar with my case.  Apparently all the pathologists there
were because of its, um, uniqueness.  They told me that they were 100% sure
that I was Her2+  If there is any possible doubt they redo the test.  My score
was (3+)

<< How can a biopsy report {cytopathology report} show ER positive, and PR
"weakly positive" and then report after surgery {mast} show both these
as being negative? >>

OOPS other post was sent too soon--am having a bit of hard time with my mouse
due to misplaced mouse pad--was going to use it for new computer (in other
location) but was too big and well, can't seem to find it--so while trying to
copy other post (not yet finished) in case I was knocked off line so it
wouldn't be lost, I accidentally sent it.
So, what I was going to say, was that the pathologists at our HMO told us they
were very sure that I was Her2+ and if they hadn't been would have re-tested
with other test.  The outside pathologist questioned it because he said that
only 5% of those with lobular are Her2+  However, I subsequently read that
Her2+ does seem to go along with pleomorphic lobular.  Besides they were quite
careful about positive identification--being a non-profit HMO.  They were not
going to spend $66,000.00 for a year of Herceptin if it wasn't indicated.
Also, my surgeon who specialized in breasts and children--told me that I was
only the 2nd of her patients at that time to test positive for Her2+ (at that
level) in the year that they had been testing for it.
Anyway, outside opinions concurred with original pathology reading.  However,
many times they don't.  That is one reason that pathology is re-examined at
time of 2nd opinions which my general surgeon had recommended at visit when she
discussed results.
As far as your tests showing mixed results, I have read of cases like that
before.  Although there could have been an error, what you describe could
result from the fact that different samples were analyzed.  Not all are alike.
It is possible that the initial biopsy indicated one thing but the 2nd may not
have shown a high enough # of positive cells to be considered positive although
they did indicate 'weakly positive' for PR.  I am guessing that if correct that
the pathology slides were different from what was found at time of surgery.  Do
you know if there was more than one tumor involved?  In the case you describe,
it seems a second reading of both sets of slides may be warranted.  If ER was
even weakly positive, it is thought by some that hormonal treatment might be
helpful.