A pathology report plays a crucial role in diagnosing breast cancer. After a tissue sample is taken during a biopsy or surgery, a pathologist examines it under a microscope and writes a report of their findings, called a pathology report. If the report shows that breast cancer is present, the oncology team will use the information to determine the stage and recommended treatment plan.
Pathology reports can be hard to understand because pathologists may describe findings differently or in scientific terms that most people aren’t familiar with. Your oncologist will know what the information means and can explain it to you. The following sections may be included in the report:
This section outlines the specifics of the tissue sample, including its origin (e.g., breast, lymph nodes).
This section provides information about the patient's medical background, details about the biopsy or surgery, and the doctor's initial diagnosis.
This section outlines the visible characteristics of the removed tissues, such as size, weight, color, texture, and other distinctive features before microscopic examination.
This section provides a detailed summary of the microscopic findings, including the presence and spread of cancer cells. The report distinguishes between:
The margin is the area surrounding the suspected cancer tissue removed during a biopsy or surgery. A positive margin indicates the presence of cancer cells at the tissue sample's edges, while a negative margin indicates their absence. A "close" margin means that cancer cells are not present at the edge but are close to it.
Also referred to as the mitotic rate or Ki-67, this measurement assesses the speed at which cancer cells grow and divide to generate more cancer cells. A higher value typically indicates a more aggressive form of cancer.
The final diagnosis summarizes the breast cancer's key characteristics, including the type of cancer, tumor grade, lymph node involvement, hormone receptor status, and HER2 status, guiding the next steps in patient care.
There are several types of breast cancer. The pathologist will provide this information in the report. If lobular carcinoma in situ (LCIS) is the determination, it is not considered cancer. LCIS is an overgrowth of abnormal cells in the milk glands or lobules, indicating an increased risk of developing invasive cancer in the future. You should discuss a more frequent breast cancer screening plan with your physician.
Common types of breast cancer in pathology reports include:
Less common types of breast cancer include:
The grade indicates how closely the cancer cells resemble healthy breast cells and how quickly the tumor might grow and spread. It is assessed based on the features of the tumor cells and tissue using grading scales such as the SBR system or descriptions like well differentiated, moderately differentiated, or poorly differentiated.
Vascular invasion refers to the spread of cancer cells through the lymph channels or blood vessels, while lymph node involvement indicates that the cancer is likely to spread to other areas. The presence of cancer cells in the lymph nodes are categorized as:
The hormone receptor status of breast cancer refers to whether the breast cancer cells are fueled by estrogen and/or progesterone due to hormone receptors found on the cancer cells. The status is indicated by one of these:
HER2 is a protein that manifests on the surface of breast cells but may be overexpressed in certain cancer types. If detected, the report will specify a HER2-positive status.
Cancer staging guides treatment decisions and provides insight into the patient’s potential prognosis. It also helps organize information using common terminology that all care team members can understand. While the breast pathology report does not include a stage, it includes information that allows the oncologist to define one.
Breast cancer is staged using the TNM system, which stands for:
Numbers or letters following T, N, and M offer more detailed insights into each characteristic. Higher values note a more advanced stage of cancer.
Additionally, a number on a scale of 0 to IV (Roman numeral four) typically represents the stage of breast cancer. Stage 0 refers to non-invasive cancers confined to their original sites, whereas stage IV notes invasive cancers that have grown beyond the breast to other parts of the body. This is called metastatic breast cancer.
Learn more about breast cancer staging.
Genetic testing is not typically performed on biopsy samples to look for inherited genetic mutations. This is because only 5-10% of all breast cancers are related to a BRCA1 or BRCA2 gene mutation. Talk to the oncologist about any family history of breast cancer to see if further genetic testing should be done.
New York Oncology Hematology provides the latest breast cancer treatments in the Albany region. One of our breast cancer specialists will carefully review your pathology report and explain the information to ensure you understand your diagnosis. They will also provide a suggested treatment plan.
You can request an appointment at one of our locations throughout the Capital District, including Albany, Amsterdam, Hudson, Troy, and Clifton Park, New York. Second opinions are also available.