After Surgery Comes the Pathology Report


Within about a week after your surgery, your doctor will receive a written report from a pathologist, a doctor who examined the tissue removed during your surgery. The pathologist's report will contain his or her findings based on a thorough examination of your breast tissue. The report will include a breast cancer diagnosis, and information about the actual size, shape and look of your cancer.

Staging is also a part of the pathology report.

Staging identifies where cancer is or traveled to in the body. This information helps the care team determine the best course of treatment for your cancer.

There are two types of breast cancer staging:

  • Clinical staging encompasses results of a patient's physical exam and tests.
  • Pathologic staging, which is the usual way of staging breast cancer, comes from the pathologist’s examination of the tumor tissue and lymph nodes taken out in surgery.

The most often used staging system is the TNM system. It stands for tumor, nodes, and metastases.

When staging, TNM considers:

  • The size of the tumor (T)
  • The number and location lymph nodes (N) with cancer
  • Has cancer spread to other areas of the body (metastasis) (M)?

The pathology report will identify if:

  • You have more than one tumor in the affected breast.
  • The cancer is invasive and spread into other areas of the breast.
  • Cancer has spread to the lymph nodes under the arm.
  • Cancer spread to the nipple and the skin.
  • The cancer is either estrogen positive or negative
  • The tumor removed has cancer-free margins around the tumor.

The pathology report will also identify the aggressiveness of the tumor and whether or not it has traits that might make it less responsive to certain treatments.

After your surgeon reads the report, he or she will ask you to meet with him or with a medical oncologist to review the results of the report and answer questions you may have. He or she will then discuss your proposed treatment plan based on the findings in the pathology report.

This can be a very stressful meeting. It is important to bring someone with you to the meeting who can take notes and ask the questions you may forget to ask. Don't allow yourself to feel rushed; ask as many questions as you need to understand the need for the treatment being recommended.

Ask what is entailed in each of the treatments, the length of treatment, short and long-term side effects, and whether or not you will be able to work during treatment.

Don't feel pressured to agree to the treatment plan; get a second opinion. Ask for a copy of your pathology report to take with you. It is yours; you are entitled to have it.

Take time to digest what you have been told.

You need to consider your comfort when deciding where you will have chemotherapy or radiation, should you need these treatments.

Decide where you want to take treatment by visiting the facility first. Assessing the quality of care and comfort of a facility or treatment area begins in the reception area. Is staff courteous, friendly, and helpful? Is the reception area attractive?  Since radiation is always given in a private area, changing rooms and waiting areas are what you need to pay attention to.

When it comes to picking where you will be comfortable getting your chemo infusions, the most important area is the infusion area itself. Does each patient have a private cubicle equipped with a recliner chair and seating for a visitor? Privacy is so important when you are feeling unwell, or frightened.

Some chemo facilities have little to no patient privacy. Patients receive treatment sitting in groups, in close proximity to one another.  Not pleasant if one or more patients are feeling unwell.

Once you have gotten a second opinion, chosen your chemotherapy and radiation sites, and met with the treatment teams at both sites, you are ready to begin the next phase of treatment.

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