Understanding a Pathology Report
Excerpted from The Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 20, 2014
What is a pathology report?
A pathologist is a doctor who specializes in diagnosing diseases by examining tissue from the body. You will probably never meet the pathologist, but samples of your tumor tissue, removed during surgery or biopsy, will be sent to him or her for review. The pathologist prepares a report of their findings, which is called the pathology report. This report contains important information about the tumor that is used to make treatment decisions. You should request a copy of this report and keep it in your personal files.
What will you find on a pathology report?
Your healthcare provider will typically receive the pathology report within a week to 10 days from the time of the surgery or biopsy. These reports are written in medical language. The pathology report is broken down into several sections, often including:
- Patient information: Name, birth date, biopsy date
- Gross description: This is generally not that important to you, the patient. It is a description of what the pathologist received and what they see with the naked eye. The pathologist may describe the color, shape, feeling and size of the tissue. After a cancer surgery, multiple organs or tissues may be submitted and described in the report.
- Microscopic description or diagnosis: This is the meat of the report and contains the most useful information. Not every report goes through the microscopic diagnosis in the same order and some use different terms to describe the same thing. In addition, different cancer types will have different things reported in this section. Some things you may find include:
- Type of cancer or type of tumor cells.
- Size of the tumor in centimeters.
- Grade (how abnormal the cells appear under the microscope).
- Invasion, or how deep the tumor extends.
- Margins are the area at the edge of the specimen that was submitted. When performing a cancer surgery, the surgeon attempts to remove the entire tumor and some normal tissue surrounding it. This area of "normal tissue" is important because any stray cancer cells may be included in this. If the edge (or margin) contains tumor, there may have been cancer cells left behind. The goal of surgery is to achieve a "clear margin", that is, clear of any cancer cells.
- Lymph nodes – if tested, the report will include whether cancer cells were found in the lymph nodes submitted.
- Other information may be included depending on the type of cancer. This can include special stains/dyes or genetic tests that identify abnormalities associated with a specific cancer type.
Keep in mind that some tests may be done at a different laboratory and it may take longer to get those results. Some pieces of the report are used to determine the stage of the cancer and most pieces play a role in deciding what treatment is needed. By understanding the basics of the report, you will be better able to discuss your treatment options with your healthcare team.
Second opinion on pathology
Although most cancers can be easily diagnosed, sometimes patients or their doctors may want to get a second opinion about the pathology results, particularly in the case of a rare cancer or an uncertain diagnosis. Patients interested in getting a second opinion should talk with their doctor. They will need to obtain the tissue samples from the pathology lab that examined the sample or from the hospital where the biopsy or surgery was done.
Many institutions provide second opinions on pathology specimens. Centers designated by the National Cancer Institute or academic institutions are reasonable places to consider. Patients should contact the facility in advance to determine if this service is available, the cost, and shipping instructions
Resources for further information
College of American Pathologists: How to read your pathology report.
NCI: Pathology Reports