Throughout the sections of the pathology report detailed above is plenty of information about the tissue sample that was gleaned from observations and tests. It will give basic information such as where the sample was located on the body and what its size and shape is as well as more detailed medical information.
The report will indicate whether the cancer is invasive or in situ. If it is in situ, it has not yet spread from its point of origin. If invasive, it has moved to other parts of the breast. It will also indicate where the cancer is located in the breast, in the ducts or the lobules. Ductal carcinoma is much more common.
Most pathological reports will include a histolopathologic grade. This is reported on a scale called the Bloom Richardson scale and indicates the shape of the nuclei in the sample cells, their division rate, and how closely the cells resemble healthy breast tissue. Each gets a score of one, two, or three. Scores of three indicate the most aggressive cancer.
Surgical margins are reported to indicate whether or not more surgery is needed to completely remove the cancerous cells. When all have been removed, the margins are reported as clear. Because breast cancer most commonly spreads to lymph nodes first, they are often removed for testing. The report will describe which and how many nodes were removed and whether or not they contain cancerous tissue.
A hormone receptor status is reported to indicate whether the sample cells are sensitive to hormones. Cancerous breast cells may have estrogen receptors (ER positive) or progesterone receptors (PR positive). If the cells do not have receptors or only have them in low amounts, the report will read ER or PR negative. If the report is positive for hormone receptors, that patient may benefit from hormone therapy as a treatment.
HER2 status is reported as positive or negative. HER2 is a gene that produces a protein that behaves as a receptor on cell surfaces. It interacts with growth factors that tell the cells to grow and divide. A status of HER2 positive indicates that the cancerous cells are growing and dividing rapidly and the cancer is aggressive.
The Ki-67 proliferation index is a result on the pathology report that describes the presence of a cell proliferation antigen. This index reports the percentage of cancer cells that have positive nuclear staining. The higher the percentage, the more aggressive the cancer is. Ten percent or less is a favorable result.
Finally, the pathology report will designate a stage for the cancer, from one to four. One is the least advanced cancer and four is metastatic or cancer that has spread to other parts of the body.
Reading a pathology report can be confusing and frightening. Often the terms and results sound bad even when they are not. Armed with the right information, a woman reading her report will understand what it means and be prepared to consider treatment options.
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