The pathology report
When breast tissue is removed during a biopsy, it is sent to a pathologist. The pathologist looks at it under a microscope and determines if the tissue cells are cancerous or not. He/she then prepares a report of the findings, including the diagnosis, and sends it to the ordering physician (either your surgeon or your oncologist). When needed, the pathologist does more tests on the tissue sample. These results may be written up in separate reports, so you may get more than one report for the same biopsy. Along with other test results or X-rays, the pathology report(s) guides your diagnosis, prognosis and treatment. Ideally, an interdisciplinary team that includes your oncologist, radiologist, surgeon and pathologist will plan your treatment.
Your pathology report contains the information that describes your diagnosis. It is important not to focus on any one item on the report since it is the sum of all the information that is most important to your prognosis and treatment. Your physician (either your surgeon or your oncologist) will go over the main findings of the report with you and answer your questions. It is a good idea to ask for a copy of your pathology report from your health care provider for your personal medical records. Also, it can be hard to take in all the findings on the report at once and having a copy that you can refer later is helpful.
Find questions to ask your health care provider concerning your pathology results .
Experience of the pathologist and pathology laboratory
An accurate diagnosis leads to the best treatment possible. Therefore, the skill of your pathologist is important. You want to make sure your tissue sample is handled properly and diagnosed correctly. One way to do this is to ask your provider about the experience of the pathologist and the pathology laboratory prior to the biopsy. Below are some questions you may find useful.
- Who will evaluate my biopsy sample?
- How much experience does that person have with breast cancer?
- How much experience does that pathology lab have with breast cancer?
- How long will it take to get the test results from the pathology lab?
Preserving your biopsy tissue
It is standard for hospitals in the United States to preserve and store all biopsy samples as formalin fixed paraffin embedded tissue. When a sample arrives at the pathology lab, it is treated with a substance called formalin, which hardens the tissue and keeps it from breaking down over time. Later, if you wish to have your biopsy tissue re-examined for a second opinion, or if a new test becomes available that could affect your treatment, the preserved tissue can be obtained from the hospital where the biopsy procedure was done.
Read our report on breast pathology practices.
Second opinions
Second opinions can be useful in getting the most accurate diagnosis possible. They are especially useful in getting an accurate diagnosis for rarer types of cancers (such as metaplastic breast cancer) that are hard to diagnose. For more on rare types of breast cancer, visit the Diagnosis section. Although second opinions may not always be needed, and sometimes are not covered by insurance, it is a good idea to consider getting one. Learn more about getting a second opinion.
What's not on a pathology report
Stage/pathologic stage and clinical stage
Breast cancer stage is determined by tumor size, lymph node status and the presence or absence of metastatic cancer. It is not listed on most pathology reports because it is derived from the results of the biopsy, any biopsies of the lymph nodes and other tests. These biopsies and some pathology tests may not be done at the same time. Thus, you may have more than one report that contributes to staging. Your medical team combines all the pathology information with any scans (to check for spread to other parts of the body), and determines the breast cancer stage. Find out more on breast cancer staging.
Updated 10/27/09
