Reading The Pathology Report - A Layperson’s Guide To Understanding Your Breast Cancer Diagnosis

“Have you got your pathology report yet?”

As a woman newly diagnosed with breast cancer, it seems that everything hinges on this all-important document. Will you have chemo? Is a lumpectomy “good enough?” And how about those hormone drugs: yes, or no?

Here's an example of what your pathology report might look like.

Your pathology report is compiled by a pathologist, a doctor who specializes in the microscopic examination of tissue to identify abnormalities. The report is based on the tumor or other cancerous tissue surgically removed from your breast. It includes a wealth of information used to make treatment decisions. It’s the starting point of your journey through cancer, a map your oncologist relies upon to determine your best path to remission or a cure.

But with all of that—why is the darned thing so hard to read and understand?

Because even though the pathology report is about you, it’s not really for you. It’s a summary of information passed among doctors; and let’s face it, they don’t speak the same language we do.

So you’re left with a document that’s literally used to make decisions in a life-or-death situation—YOUR life-or-death situation—and you can’t understand it. What’s a survivor to do?

First, if you don’t already have it, ask for a copy of your pathology report. It’s a simple matter for your oncologist to print it out for you. Once you have the report, you’re ready to go over it, step by step, using this easy guide.

Pathology reports are written in different styles; and they may present the information in slightly different sequences. But in general, they’ll contain the same information: a complete analysis of your breast cancer: type, aggressiveness, extent, and other attributes your oncologist will look at as a whole to make his or her best determination about your treatment.

Aside from the very first section—the demographics, which list your name, your doctor’s name, date of surgery, etc.—the information may be presented in any order. So be prepared to flip around in your report to find the sections explained below.

Ready? Let’s jump in.

Demographics

First, make sure it’s your pathology report. Seems silly, but it pays to check the very top of your report, which will list your name, date of birth, your doctor’s name, and date of surgery/biopsy. If any of these facts are wrong, question your doctor. The last thing you need is the results of someone else’s report.

Gross Description

This is the pathologist’s description of what your tissue sample—the tumor, and surrounding tissue—looked like to the naked eye, as well as how it was prepared for microscopic examination. The size of the sample, weight, and other observations made by the pathologist (e.g., adipose tissue, fibrous tissue, stained with blue dye from sentinel node…) are all noted.