NCCN Guidelines for Patients
Stages I and II Breast Cancer, Version 1.2014
Lymph node biopsy
cancers have cells with more than two copies of the
HER2 gene causing too many HER2 receptors to be
made. Other breast cancers have cells with only two
HER2 gene copies but still too many HER2 receptors
With too many HER2 receptors, breast cancer cells
grow and divide fast. However, there are drugs to stop
these cancer cells from growing. Due to high costs
and the side effects of these drugs, it is very important
to have tests that correctly show HER2 status. Like for
hormone receptors, IHC is used to count the number
of HER2 receptors. An IHC score of 3+ means that
the cancer cells have many HER2 receptors. Another
test of HER2 is ISH (in situ hybridization). ISH counts
the number of copies of the HER2 gene. If the cancer
cells have too many HER2 genes or receptors, the
cancer is called HER2 positive.
Lymph node biopsy
Removing tissue samples
You’ve learned that you have cancer in your breast,
but the cancer may have spread to your lymph nodes.
If your lymph nodes feel large upon physical exam
or don’t look normal in imaging scans, there is a
higher chance that cancer is in them. To tell if cancer
is present in your nodes, a sample of tissue must be
removed. The removal of tissue is called a biopsy. A
biopsy is generally a safe test.
Before a biopsy, you may be asked to stop eating, stop
taking some medicines, or stop smoking. For a needle
biopsy, your doctor will insert a needle though your
skin into your lymph node.
See Figure 4
for pictures of
needle biopsies. The biopsy samples will be sent to a
lab and tested for cancer cells. Further testing of your
lymph nodes may be done at the time of surgery even
Illustration Copyright © 2014 Nucleus Medical Media, All rights reserved.
Figure 4. Lymph node biopsies
Core needle biopsy