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Your move, Alexa. But as smart speakers from Amazon, Apple, Google and other technology giants proliferate global sales more than doubled last year, to So how worried should you be that your speaker is spying on you? For years the tech industry has dreamed of computing appliances that are considered unremarkable items of household machinery, like washing machines or fridges. The smart speaker has finally realised this promise. It can sit on a kitchen counter and summon the wonders of the internet without the need for swiping or typing.

Using it is like casting a spell. Say the magic words and you can conjure up dodgy Eighties rock while up to your elbows in washing-up, or prove to your mum that Ronaldo has scored more goals than Messi. This hands-free convenience has a cost: the speakers are constantly listening out for commands. As with any advanced and apparently magical technology, however, myths quickly grow up about how they work. So start with some myth-busting. Despite their name, the devices are simple-minded. They listen out for wake words, and then send what follows to the cloud as an audio clip; when an answer arrives, in the form of another audio clip, they play it back.

Putting all the smarts in the cloud means these speakers can be very cheap and acquire new skills as their cloud-based brains are continually upgraded. As part of this improvement, manufacturers such as Amazon store sound clips of queries, so they can be assessed by humans if necessary. But Amazon notes that users can delete these clips at any time. Users, the firm insists, are in control. Not everyone is convinced by such assurances, however.

Microscopic description

What if hackers infiltrate the devices? Could governments require manufacturers to provide back doors? Are their makers using them to snoop on people and then exploiting that information to target online ads or offer them particular products? Some people refuse to let Alexa and Siri into the house. If eavesdropping is your problem, eschewing smart speakers does not solve it.

Smartphones, which people blithely carry around with them, are even worse. Spy agencies are said to be able to activate the microphone in such devices, which have even more sensors than smart speakers, including location-tracking GPS chips and accelerometers that can reveal when and how the phone is moving. HER2 status helps guide your treatment. Most often, IHC is the first test done. Results of an IHC test. Results of a FISH test.

Learn more about HER2 status and prognosis. Learn more about treatment with trastuzumab Herceptin and other HER2 targeted therapies. When breast cancer is surgically removed during a surgical biopsy, lumpectomy or mastectomy , a rim of normal tissue surrounding the tumor is also removed.

This rim is called a margin.

The pathologist looks at the margins under a microscope and determines whether or not they contain cancer cells. This helps show whether or not all of the tumor was removed. Lympho-vascular invasion occurs when cancer cells enter lymph channels or small blood vessels. This may suggest a more aggressive tumor. If lymph nodes in the underarm area axillary lymph nodes were removed during surgery, the pathologist looks at them under a microscope and determines whether or not they contain cancer. In general, lymph node-negative breast cancers have a better prognosis than lymph node-positive breast cancers.

Learn more about lymph node status and prognosis. Learn more about lymph node assessment. The following items are included in all pathology reports, but don't impact prognosis or treatment. This section of the report has basic information including your name, medical record number, date of birth, age and sex, date of the biopsy and name of the health care provider who ordered the report most often your surgeon.

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It's a good idea to check all this information to make sure you have the correct pathology report. This is a description of the type of biopsies used to remove the tissue sample and lymph nodes if lymph nodes were removed. The clinical history describes the initial diagnosis before the biopsy and sometimes, a brief summary of your symptoms. If you had breast cancer in the past and the biopsy tissue is available, the pathologist often will review this tissue to distinguish the recurrence of a past tumor from a new breast cancer. One of the first things the pathologist does when he or she receives the biopsy tissue is to take measurements and record a description of the tissue as it appears to the naked eye without a microscope.

This gross description may include the size, weight, color, texture or other features of the tissue and any other visual notes. If there are multiple samples, there's often a separate gross description section for each sample. In these cases, the pathologist assigns a reference number or letter to each tissue sample to avoid confusion.

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The gross description also includes information on how the sample was handled once it reached the pathologist. Some of these tests are only done for certain diagnoses.

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Others are not routinely done because they don't predict prognosis better than standard measures or because they are not reliable measures for all tumors. The proliferation rate is the percentage of cancer cells actively dividing. In general, the higher the proliferation rate, the more aggressive the tumor tends to be. Proliferation rate could be a good predictor of prognosis.

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However, there are issues related to its measurement. The Ki test is a common way to measure proliferation rate. When cells are growing and dividing proliferating , they make proteins called proliferation antigens. Ki is a proliferation antigen. MIB1 is the antibody most often used to label the Ki antigen.

The more cells MIB1 attaches to in a tissue sample, the more likely the tumor cells are to grow and divide rapidly. A higher value shows a higher proliferation rate. Learn more about understanding your pathology report. How to Read Your Pathology Report. Breast Cancer: Path to Treatment.

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Contents of a Pathology Report Pathology reports are written in medical language because they are prepared for health care providers. Needle biopsy reports may contain less information than surgical biopsy reports. Diagnosis or final diagnosis This is the most important section of the report. This information may appear grouped together or as separate sections.

Microscopic description The microscopic description details what the pathologist saw and measured when he or she looked at the biopsy tissue under a microscope. The best way to measure tumor size is under a microscope especially for small tumors. In general, the smaller the tumor, the better the prognosis tends to be.

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Non-invasive vs. Tumor grade For invasive breast cancers, the pathologist notes the shape of the cancer cells and assigns a histologic grade, using either a number system or words. The most common grading system in current clinical practice is the Nottingham system: Grade 1. The tumor cells look the most like normal tissue and are slow-growing well-differentiated. Grade 2. The tumor cells fall somewhere in between grade 1 and grade 3 moderately-differentiated. Grade 3. The tumor cells look very abnormal and are fast-growing poorly-differentiated. Nuclear grade The nuclear grade describes how closely the nuclei of cancer cells look like the nuclei of normal breast cells.

Hormone receptor status Hormone receptors are proteins found inside some cancer cells. Hormone receptor-negative breast cancers are not treated with hormone therapy. HER2 status HER2 human epidermal growth factor receptor 2 is a protein that appears on the surface of some breast cancer cells.

The HER2 protein is an important part of the pathway for cell growth and survival.