Thank you all so much for welcoming me back to the Forum.
Mindy -- no need to apologize. I've seen the article you referred to; it's a very informative review. There is also this
http://www.archivesofpathology.org/doi/full/10.1043/1543-2165-133.10.1515, which is the recommended protocol from the College of American Pathologists for evaluating breast path specimens. I am getting my care at a NCCN facility here in town. In my case, the path was initially read by a 1st year pathology resident, then signed off by the attending pathologist (the fellow I mentioned earlier). At the re-review, my case was supposedly presented at a breast consensus conference. Even then, the amended report had only one additional comment, which was in direct contradiction to the previous report, regarding residual tumor size. And still no mention of tumor bed, cellularity and how they arrived at the ypT staging. Incidentally, when I tried to ask my surgeon about the ypT staging, to my surprise she said she didn't know what ypT stood for (the NP knew and I think embarrassed).
Another problem with my path is that the receptors changed from ER4%,PR3%,Her2,1+ to now 0,0,0 on the residual tumor. Is this sampling error, treatment effect, or technical issues? If they are going to give me 5 years' of aromatase inhibitor that will worsen the osteoporosis that I already have, I sure want to have some confidence in the immunohistochemistry results.
My beef is with pathologists and radiologists. We really need a face-to-face with these docs that interpret some of the most critical decision-making testing, yet, they are loathe to have direct patient contact (my experience); on the other hand, they sure charge enough.
Donna -- I hope that at least the 2nd opinion was worth the effort. When I look at the clinic notes for my case, I am always surprised at the number of factual errors I find -- sometimes I try to tell the concerned party about the error(s) if they are important enough (which they may or may not correct).