Tests on breast tissue

If tests on the biopsy sample show that it is breast cancer, extra tests will be done to work out the factors shown here and help plan treatment. Your surgeon may suggest leaving some of these tests until the whole lump is removed and examined after surgery. The results will be included in the pathology report.

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tests on breast tissue

Hormone receptor status

Hormones are chemicals in the body that transfer information. Both women and men produce the female sex hormones oestrogen (ER) and progesterone (PR), although the levels are lower in postmenopausal women and in men.

A hormone receptor is a protein in a cell. Most breast cancers have cells with hormone receptors that receive signals from oestrogen or progesterone, so these hormones may be helping the cancers grow. These cancers are called hormone receptor positive (ER+ and/or PR+) or hormone sensitive cancers. They are likely to respond to hormone therapy that blocks oestrogen.

HER2 status

HER2 (human epidermal growth factor receptor 2) is a protein that is found on the surface of cells. This protein causes the cells to grow and divide in an uncontrolled way.

Tumours that have high levels of these receptors are called HER2 positive (HER2+). Tumours with low levels are called HER2 negative (HER2−). Treatment with targeted therapy, such as trastuzumab (brand name Herceptin), as well as chemotherapy, is usually recommended for HER2+ breast cancer.

Triple negative breast cancer

Some breast cancers are hormone receptor negative (ER− and PR−) and HER2 negative (HER2−). These are called triple negative cancers.

Triple negative cancers do not respond to hormone therapy nor to targeted therapy aimed at HER2. However, triple negative cancers often respond well to chemotherapy.

As triple negative is a less common form of breast cancer, you may find it helpful to talk to other women with a similar diagnosis. See Support Services for peer support services.

Genomic assays

Genomic assays, also called molecular assays, are tests that look at the patterns of certain genes within the cancer cells. These patterns help predict the risk of the cancer coming back, and this information helps guide treatment. For example, if there is a low risk of the cancer coming back, you may not need chemotherapy.

The genomic assays that are currently available are only for breast cancer that is ER+ and HER2−. They include the Oncotype DX Breast Cancer Assay, EndoPredict and Prosigna. These tests can cost up to several thousand dollars and are not currently covered by Medicare or private health funds.

It is important to remember that the standard pathology tests that are done on all breast cancers often provide enough information to guide treatment plans. If you and your oncologist decide that it is worth having a genomic assay, the test you choose will depend on a number of factors, including your doctor’s experience. Your doctor can provide you with further information.

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Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059


To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in August 2018
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Cancer information

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What you can reasonably expect from your health care providers

Making cancer treatment decisions
Decision-making steps, consent and second opinions