When you find out that you have breast cancer, your pathology report is a key document in your health records.
A pathology report explains what a doctor called a pathologist found when examining a piece of your tissue from a biopsy or surgery. Typically, it takes a week or two after your biopsy to get a pathology report.
The report provides some details – but not all – about your cancer.
If you see your pathology report in your patient portal before you’ve had a chance to talk to your doctor, it can be easy to misunderstand or take things out of context.
Your doctor will go over the findings with you. But it can be helpful to know what the report might include and what it means for your treatment going forward.
What’s in a Breast Cancer Pathology Report?
While the format will vary depending on your health care provider, it will typically include:
Information about you: The first section of your report will include basic information such as your name, age, medical history, and the date of the biopsy.
A diagnosis: This section of the report will state whether the checked tissue is:
If you have invasive breast cancer, that means that it has spread beyond where it started into the surrounding breast tissue or further to the lymph nodes or other parts of the body. The report may further state whether you have invasive lobular breast cancer or invasive ductal cancer. This refers to whether the cancer is in the breast’s lobules (glands that make milk) or ducts (tiny tubes that bring milk from the lobules to the nipple).
A description of the tumor: This may have two parts: a “gross” description, which is what it looks like to the pathologist’s eye, and the micro description, which is how it looks under the microscope.
The report may also include the results of a “hormone assay.” This tells you if the cancer cells have receptors for the hormones estrogen, progesterone, or neither. Your doctor will use these results to help determine whether the cancer could respond to hormone therapy.
The grade of the tumor: The report may give a grade from grade 1 to grade 3 to your tumor. Grade 1 tumors are slower growing and less likely to spread, while grade 3 is the fastest growing.
Why Your Breast Cancer’s Stage Isn’t in the Pathology Report
The report will not tell you the stage of cancer that you have. But the pathology findings are one of the things that doctors use to determine the cancer’s stage.
To stage the cancer, doctors also consider things including whether the cancer has spread to nearby lymph nodes or to more distant parts of the body. That requires other scans or tests than what they can learn from analyzing the tumor itself. Finding out the stage of your cancer may also require a core biopsy or surgery.
What to Ask Your Doctor
When you talk with your doctor to go over your pathology report, you should ask them to clarify anything that you don’t understand about the report, your diagnosis, or your treatment plan.
“Many patients come in with their pathology report marked up with circles and highlights because they want to make sure that they understand everything there,” says Lauren Nye, MD, a medical oncologist at the University of Kansas Cancer Center.
You may want to have a friend or family member join the phone call or visit to discuss your pathology report, so you have good support and record of everything discussed. It’s often hard to take the notes yourself.
What Happens After the Pathology Report?
If you got a breast cancer diagnosis, your doctor will likely refer you to a breast specialist.
“The breast specialist will be able to put the whole picture together, including a physical exam, the mammogram, the ultrasound, and an MRI to formulate a plan for treatment,” says Stephanie Bernik, MD, chief of breast surgery at Mount Sinai West. “It varies from person to person more than it did in the past.”
If you have surgeries or biopsies later on, each one will generate a new pathology report.