What is a pathology report and why is it important?

Pathology reports provide important information about your breast cancer. When breast tissue is removed, a pathologist, a doctor who specializes in examining tissue and diagnosing disease, examines it under a microscope. A preliminary pathology report is prepared after a breast biopsy. A more detailed report is prepared after your breast surgery (lumpectomy or mastectomy). Only after gathering all of the details in your pathology report can your surgeon determine the next steps in your treatment.

 What kind of information is contained in a pathology report?

 The report describes the characteristics of your tumour, such as:

  • Size of tumour
  • Margin status – whether there is a rim of normal tissue around the tumour or cancerous cells extend to the edge (or margin) of the removed tissue
  • Lymph node status (whether cancer cells are present in the lymph nodes)
  • Grade (how fast the cancer cells are growing)
  • Vascular or lymphatic invasion (whether cancer cells are found in the blood vessels or lymph vessels of the breast)
  • Hormone receptor status (whether the cancer is sensitive to the influence of the hormones estrogen and/or progesterone)
  • HER2 status (whether the cancer cells “overexpress” or have too much of a protein called HER2)

What is staging and why is it important?

Staging consists of clinical examinations and tests done to determine the extent, or stage, of the cancer. Staging considers the size of the cancer and whether it has spread to nearby breast tissue or other parts of the body.

Staging is important because it will help determine the best treatment plan. The pathology report that is prepared after your surgery will provide information necessary to determine the stage of your breast cancer. Sometimes additional tests may be required.

Breast cancer can be classified in the following stages:

STAGE 0: This is noninvasive DCIS (ductal carcinoma in situ); the cancer stays within the ducts of the breast. Some consider this to be pre-cancer.

STAGE I: This is early invasive breast cancer. The tumor is 2 cm or less and cancer has not spread to lymph nodes

STAGE II: This is still considered early invasive breast cancer, but the tumour is larger (2 – 5 cm) and/or the cancer has spread to a few nearby lymph nodes.

STAGE III: This is locally advanced breast cancer. The tumor is either larger than 5 cm, or extends to the chest wall or involves the skin of the breast, or has spread to many nearby lymph nodes.

 STAGE IV: This is metastatic or advanced breast cancer. The cancer has spread to other parts of the body, such as bone, liver, lungs, or brain.

How accurate are the survival statistics related to the type and stage of cancer I have?

Cancer statistics summarize information collected from large groups of people. They can only make general statements about the group of people from which the information was collected. But no two people are alike, and statistics can’t tell you what will happen to you. You and your situation are unique. Also, it is important to remember that most statistics are collected over a period of time in the past, and treatments continue to evolve, leading to better outcomes. Your medical team is always best suited to address your particular situation and advise you on your outlook.

Links to more information

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Your Guide to the Breast Cancer Pathology Report

Breast Pathology
American Cancer Society

Understanding Your Pathology Report
Living Beyond Breast Cancer

Pathology FAQ: Breast Cancer

Stages of Breast Cancer
National Cancer Institute