1. What is the stage of my cancer?
Rationale: In some cases, your team may tell you the stage of your cancer right at diagnosis. Other times exploratory surgery is needed to clarify the stage. Staging is important to treatment and prognosis.
2. What is the grade of the tumor?
Rationale: After surgery, the tumor is sent to a pathologist. Tumor cells are given a "grade" or a "level of differentiation." Differentiation refers to how cells look and behave under a microscope. The degree of differentiation is an important consideration for prognosis and is often used to direct treatment. The tumor grade may be reported as grade 1-4 or as: well, moderately, or poorly-differentiated. Well-differentiated or moderately-differentiated cancer cells look and behave similar to normal cells, they are slow-growing and less aggressive cells which correspond to grades 1-2. Undifferentiated or poorly-differentiated cells do not resemble normal cells, they tend to grow quicker and be more aggressive they correspond to grades 3-4.
3. Does tumor pathology show HER2/neu mutation?
Rationale: A HER2 mutation leads to the over expression of an oncogene (a gene implicated in cancer). HER2 status is an important predictor of prognosis. There is a special targeted medication called transtuzumab (marketed as Herceptin) which may be recommended to HER2-positive patient which improves survival.