Understanding a Pathology Report

Author: Marisa Healy, BSN, RN
Last Reviewed: August 10, 2022

What is a pathology report?

A pathologist is a doctor who diagnoses diseases by looking at tissue from the body. Samples of your tumor tissue that are removed during surgery or biopsy will be sent for testing. The pathologist writes up a report of their findings, which is called the pathology report. This report has information about your tumor that is used to plan your treatment. You should ask for a copy of this report and keep it in your personal files.

What will you find on a pathology report?

Your healthcare provider will often get the pathology report within 7 to 10 days after your surgery or biopsy. These reports are written in medical language. The pathology report is broken down into sections, often with:

  • Patient information: Your name, birth date, biopsy date.
  • Gross description: This is not that important to you as the patient. It describes what the pathologist saw with the naked eye. The pathologist may describe the color, shape, feeling, and size of the tissue. After cancer surgery, many organs or tissues may be submitted and described in the report.
    • Type of cancer or type of tumor cells.
    • Size of the tumor in centimeters.
    • Grade (how abnormal the cells look under the microscope).
    • Invasion, or how deep the tumor goes into the tissue.
    • Margins are the area at the edge of the tissue. When doing a cancer surgery, the surgeon tries to remove the entire tumor and some normal tissue around 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 have a "clear margin,” that is, clear of any cancer cells.
    • Lymph nodes – if tested, the report will go over whether cancer cells were found in the lymph nodes.
  • Other information may be included depending on the type of cancer. This can be special stains/dyes or genetic tests that find abnormalities linked 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 figure out 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 talk about your treatment options with your healthcare team.

Second Opinion on Pathology

Sometimes patients or their providers may want to get a second opinion about the pathology results, especially if it is a rare cancer or an uncertain diagnosis. If you want a second opinion, you should talk with your provider. They will need to get the tissue samples from the pathology lab that looked at the sample or from the hospital where the biopsy or surgery was done.

Many places will give you a second opinion. Centers designated by the National Cancer Institute or academic institutions (teaching hospitals) are often the most experienced with pathology reports and treatments. You can call the facility to see if they are able to give you a second opinion, the cost, and how the tissue should be shipped.

References

College of American Pathologists: How to read your pathology report.

NCI: Pathology Reports

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