Understanding Your Pathology Results
Much of the most important information about your cancer will come from your pathology report. This can seem like an overwhelming amount of information — but, as thousands of young women at YSC have experienced, understanding can help you feel more confident and hopeful.
Your Pathology Report
The pathology report gives doctors what they call “the gross description” — or a broad summary — of your cancer. It describes what the pathologist sees when looking at your tissue sample, which comes from your biopsy or surgery, under a microscope. The report may include comments on the sample’s color and size as well as the part of the breast involved.
This page will help you better understand the major parts of your pathology report so that you know what to expect from your doctors’ explanation:
- Histologic grade
- Proliferation rate (cell division)
- Hormone receptor status
- HER2 status
- Lymphvascular invasion
- Lymph nodes
- Surgical margins
Size describes how big the tumor is, usually measured in centimeters or millimeters.
Location describes where in the breast the tumor is located, usually described as a quadrant or section of the breast.
Histologic grade describes how quickly the tumor cells are dividing. Based on microscope images, doctors give a grade number from “one” (slow division) to “three” (fast division), providing a measure of how aggressive the cancer is.
Proliferation rate provides more information about how fast the cancer cells are dividing. Doctors commonly use a measure called “Ki-67” to describe the proliferation rate. A low Ki-67 means slowly dividing cells and a high Ki-67 means quickly dividing cells.
Hormone receptor status describes how sensitive your cancer cells are to the hormones estrogen and progesterone. If cancer cells have the specific receptors, these hormones can attach and give instructions to the cells to grow and divide. Doctors measure this status as a positive or negative number. Positive status can actually mean an easier to treat cancer. Read more about hormone status.
HER2/neu (Human Epidermal Growth Factor Receptor 2) status describes how sensitive your cancer cells are to the human epidermal growth factor receptor protein, which is important for cancer growth and division. If your cancer cells have excess amounts of this receptor, they can receive more messages to grow. Doctors measure the amount of this receptor in terms of positive and negative status—a more positive status means your cells have more receptor protein. Read more about this protein here.
Lymphvascular invasion describes whether breast-cancer cells have entered blood vessels or lymph nodes. From these sites, the cancer can spread to other parts of the body.
Lymph nodes test results describe how many lymph nodes had breast cancer cells in them. Lymph nodes are an important part of your immune system. During surgery, doctors remove some lymph nodes and examine them for cancer cells. They count the how many have cancer (also called “positive” for cancer). Doctors learn more about the potential spread of your cancer by the number of lymph nodes that were positive for cancer.
Surgical margin results describe whether all of a tumor was removed during surgery. Surgeons cut out additional tissue surrounding a tumor during surgery. This is called the “surgical margin.” They test the margin tissue to see if it contains cancer cells. If there are cancer cells in the margin, it means the doctor did not remove all of the cancer during surgery.