The pathology report
The breast tissue removed during a biopsy is sent to a pathologist. The pathologist is the physician who looks at the tissue under a microscope and determines whether or not the tissue contains cancer. 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. Try not to focus on any one item in 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 any questions you may have.
It is a good idea to ask for a copy of your pathology report for your personal medical records. It can be hard to take in all the findings at once and having a copy of the report you can refer to 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. So, 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 before your biopsy. Below are some questions you may want to ask.
- Who will evaluate my biopsy sample?
- How much experience does the pathologist have with breast cancer?
- How much experience does the 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 keeps it from breaking down over time. The treated sample is embedded in a block of paraffin (wax). 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 was done.
Read our report on breast pathology practices.
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.
You should feel comfortable getting a second opinion before your biopsy or after, when you have the results. Most health plans will allow you to get a second opinion, as long as the second health care provider is a member of your health plan.
Learn more about rare types of breast cancer.
Learn more about getting a second opinion.
What's not in a pathology report
Stage/pathologic stage and clinical stage
Breast cancer stage is determined by:
Stage is not always listed in pathology reports because it is derived from the results of the biopsy of the tumor tissue, 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 gives information on 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.
Learn more about breast cancer staging.