What is a Pathology Report?
Your pathology report
The tissue removed during a breast biopsy is sent to a pathologist. A pathologist is a doctor who looks at the tissue under a microscope and determines whether or not the tissue contains cancer.
The pathologist prepares a report of the findings, including the diagnosis, and sends it to your surgeon (or your oncologist).
When needed, the pathologist does more tests on the tissue sample. These results may be written in separate reports. So, you may get more than one report for the same breast biopsy.
Along with other test results and any X-rays or other imaging, the pathology report(s) informs your diagnosis, prognosis (chances for survival) and treatment.
Ideally, a medical team that includes your oncologist, surgeon, pathologist and radiologist (the doctor who read and interpreted your mammogram or other imaging) will plan your treatment.
Findings on a pathology report
Your pathology report contains the information that describes your diagnosis.
Try not to focus on any one item in the report since it’s the sum of all the information that’s most important to your prognosis and treatment.
Pathology reports are written in medical language because they’re prepared for health care providers. This can make some of the wording hard to understand.
Your your surgeon or your oncologist will go over the main findings of the report with you and answer any questions you may have.
Find questions to ask your surgeon or oncologist about your pathology results.
Learn about the contents of a pathology report.
Learn about pathology reports for people who have neoadjuvant (before surgery) therapy.
Get a copy of your pathology report
Ask for a copy of your pathology report for your medical records.
It can be hard to take in all the findings at once. It’s helpful to have a copy of the report you can refer to later.
Experience of the pathologist and pathology laboratory
An accurate diagnosis leads to the most effective treatment possible. So, the skill of your pathologist is important. You want to make sure your tissue sample(s) is handled properly and diagnosed correctly.
One way to do this is to ask your health care provider about the experience of the pathologist and the pathology lab.
Below are some questions you may want to ask before your biopsy.
- 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 results from the pathology lab?
- How will I get the results?
It’s always OK to get a second opinion on your tissue sample(s) from another pathologist.
Preserving your biopsy tissue
It’s standard for hospitals in the U.S. to preserve and store all biopsy samples as formalin fixed paraffin embedded tissue.
When a sample arrives at the pathology lab, it’s treated with a substance called formalin, which keeps it from breaking down over time.
Then, thin slices of the sample are embedded in blocks of paraffin (wax).
The preserved tissue is stored at the hospital where the biopsy was done in case it’s needed later. For example, you may wish to have your biopsy tissue re-examined for a second opinion, or a new test may come out that can be done on the tissue and could affect your treatment.
Learn more about preserving breast cancer tissue for pathology.
Second opinions can be useful in getting the most accurate diagnosis possible.
They are especially useful in getting an accurate diagnosis for rare types of cancers that are hard to diagnose, such as metaplastic breast cancer.
It’s always OK to get 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 doctor is in your health plan’s network.
Learn more about getting a second opinion.
What’s not in a pathology report
Stage/pathologic stage and clinical stage
Breast cancer stage is not usually listed in pathology reports. Your medical team combines all the pathology information from the biopsy of the tumor tissue and any biopsies of the lymph nodes with any scans (to check for spread to other parts of the body) and determines the breast cancer stage.
The biopsies and pathology tests may not be done at the same time. Thus, you may have more than one report that gives information on staging.
Breast cancer stage is determined by:
- Tumor size
- Lymph node status
- Presence or absence of metastases
- Tumor grade
- Estrogen receptor status
- Progesterone receptor status
- HER2 status
Oncotype DX® score is part of staging for some estrogen receptor-positive, lymph node-negative early breast cancers.
Learn more about breast cancer staging.