Breast Cancer Pathology

In the past, doctors usually felt that it was better for their patients to have limited access to their medical reports. Doctors wanted to interpret the medical jargon because they were worried that their patients might misinterpret and possibly distort the results they were given. However, today, this thinking had changed among most doctors. Every breast cancer patient has the right to read her pathology report, even if it holds bad news. It is important that doctors help their patients understand their bodies so that they can become an active participant in their own healing team

It is important that breast cancer specialists work closely with their breast pathologist to develop and format a report that will provide consistent and relevant information. When a second opinion is sought, it is important to review a patient's cancer tissue along with the original pathology report, which includes a description of the tissue received in the laboratory. This is also known as the macroscopic description of the cancer tissue.

It should be noted that only the original pathologist has the opportunity to view and describe the original piece of tumor. After this description is completed, the tumor is sliced into smaller pieces to make slices for further microscopic examination of the tumor. While subsequent doctors can review the slides, they must still rely on the original description of the tumor itself. It is essential for this description to accompany the slides for an accurate second opinion; it is important to the treatment plan that doctors will come up and present to breast cancer patients.

A breast cancer pathology report may contain the following information:

A preoperative diagnosis;

Gross description of the breast cancer tissue and the axillary lymph node tissue;
a microscopic description, if it is invasive, a description of the cancer cells;
and a final diagnosis, its anatomic localization, size of the specimen and the tumor; cancer stage and grade, presence of microcalcification (calcium depositions in the cancer tissue), nipple involvement and presence of spread to the lymph nodes.

The vast majority of breast cancer originates from the lining cells (epithelium) of the breast duct or the secretory cells at the terminal end of the breast duct. These malignancies are termed carcinomas. A rare variant of breast cancer is known as sarcoma, which involves malignancies of the stromal cells of the breast. The treating oncologist would go over this pathology report and apply the information from the report to the cancer patient. Significant data in addition to this report would be the patient's age, whether or not she has been on previous hormone replacement therapy, her previous medical history and so on.

Reasonable conclusion from a pathology report may be that a breast cancer patient is a good candidate for breast conservation therapy with a low probability for recurrence after radiotherapy. The risk of systemic cancer spread in this particular cancer is approximately 20 percent depending on the degree of lymph node involvement. If the patient is postmenopausal, an antiestrogenic agent, for example, tamoxifen alone or following a regimen of cytotoxic chemotherapy may be a reasonable choice for systemic therapy.

Michael Russell
Your Independent guide to Breast Cancer

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