what does the pathology report indicate about the spread of the carcinoma in this patient?

by Vivianne Schroeder 8 min read

Pathology Reports - NCI - National Cancer Institute

30 hours ago The pathology report will include the results of these tests. For example, the pathology report may include information obtained from immunochemical stains (IHC). IHC uses antibodies to identify specific antigens on the surface of cancer cells. IHC can often be used to: Determine where the cancer started >> Go To The Portal


A doctor called a pathologist studies it under a microscope. They may also do tests to get more information. These findings go into your pathology report. It includes your diagnosis, if and how much your cancer has spread, and other details.

Full Answer

What is a pathology report for cancer?

Stages of Cancer A pathology report is a medical document that gives information about a diagnosis, such as cancer. To test for the disease, a sample of your suspicious tissue is sent to a lab. A doctor called a pathologist studies it under a microscope.

When does the pathologist send a pathology report to the Doctor?

The pathologist sends a pathology report to the doctor within 10 days after the biopsy or surgery is performed. Pathology reports are written in technical medical language.

How does a pathologist determine if a tumor is cancerous?

By looking at and testing the tumor tissue, the pathologist is able to find out: If the tissue is noncancerous or cancerous. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A noncancerous, or benign tumor, means the tumor can grow but will not spread. Other specific details about the tumor’s features.

What is the gross description of a pathology report?

This information is known as the gross description. A pathologist is a doctor who does this examination and writes the pathology report. Pathology reports play an important role in cancer diagnosis and staging (describing the extent of cancer within the body, especially whether it has spread), which helps determine treatment options.

Can a pathology report tell if cancer has spread?

A pathology report indicates whether cancer has spread to nearby lymph nodes and other organs. Mitotic rate: This notes how quickly cancer cells are dividing.

What does a pathology report tell you?

A pathology report is a document that contains the diagnosis determined by examining cells and tissues under a microscope. The report may also contain information about the size, shape, and appearance of a specimen as it looks to the naked eye. This information is known as the gross description.

What is a cancer pathology report?

A pathology report is a medical document that gives information about a diagnosis, such as cancer. To test for the disease, a sample of your suspicious tissue is sent to a lab. A doctor called a pathologist studies it under a microscope. They may also do tests to get more information.

How are pathology reports used for diagnostic statements?

The specimen is analyzed by a pathologist, who then writes up a report for the medical provider who has either ordered the report or performed the procedure. Pathology reports are used by your medical provider to determine a diagnosis or treatment plan for a specific health condition or disease.

Who can interpret pathology results?

Interpreting pathology test results The treating practitioner is the most appropriate and qualified person to explain and discuss pathology test results. This is because tests represent just one of the many factors that are considered in reaching a diagnosis and planning treatment.

What is pathology diagnosis?

Pathology is a branch of medical science that involves the study and diagnosis of disease through the examination of surgically removed organs, tissues (biopsy samples), bodily fluids, and in some cases the whole body (autopsy).

How do pathologists determine cancer?

During a biopsy, a doctor removes a small amount of tissue from the area of the body in question so it can be examined by a pathologist. For most types of cancer, a biopsy is the only way to make a definitive cancer diagnosis.

What are the 4 types of pathology?

The American Osteopathic Board of Pathology also recognizes four primary specialties: anatomic pathology, dermatopathology, forensic pathology, and laboratory medicine. Pathologists may pursue specialised fellowship training within one or more subspecialties of either anatomical or clinical pathology.

What type of report contains the results of the analysis of body specimens?

A laboratory report is a report of the analysis or examination of body specimens.

What does no pathology mean?

The word "pathology" is sometimes misused to mean disease as, for example, "he didn't find any pathology" (meaning he found no evidence of disease).

What is a pathology report?

A pathology report is a document that contains the diagnosis determined by examining cells and tissues under a microscope. The report may also cont...

How is tissue obtained for examination by the pathologist?

In most cases, a doctor needs to do a biopsy or surgery to remove cells or tissues for examination under a microscope. Some common ways a biopsy ca...

How is tissue processed after a biopsy or surgery? What is a frozen section?

The tissue removed during a biopsy or surgery must be cut into thin sections, placed on slides, and stained with dyes before it can be examined und...

How long after the tissue sample is taken will the pathology report be ready?

The pathologist sends a pathology report to the doctor within 10 days after the biopsy or surgery is performed. Pathology reports are written in te...

What information does a pathology report usually include?

The pathology report may include the following information ( 1 ): Patient information: Name, birth date, biopsy date Gross description: Color, weig...

What might the pathology report say about the physical and chemical characteristics of the tissue?

After identifying the tissue as cancerous, the pathologist may perform additional tests to get more information about the tumor that cannot be dete...

What information about the genetics of the cells might be included in the pathology report?

Cytogenetics uses tissue culture and specialized techniques to provide genetic information about cells, particularly genetic alterations. Some gene...

Can individuals get a second opinion about their pathology results?

Although most cancers can be easily diagnosed, sometimes patients or their doctors may want to get a second opinion about the pathology results ( 1...

What research is being done to improve the diagnosis of cancer?

NCI, a component of the National Institutes of Health, is sponsoring clinical trials that are designed to improve the accuracy and specificity of c...

What Is Carcinoma Or Adenocarcinoma?

Carcinoma is a term used to describe a cancer that begins in the lining layer (epithelial cells) of organs like the breast. Nearly all breast cance...

What If A Carcinoma Is Infiltrating Or Invasive?

These words are used to mean that the cancer is not a pre-cancer (carcinoma in situ), but is a true cancer.The normal breast is made of tiny tubes...

What Does It Mean If My Carcinoma Is called Invasive Ductal Carcinoma, Invasive Lobular Carcinoma, Or Carcinoma With Ductal and Lobular Features?

Breast carcinomas are often divided into 2 main types: invasive ductal carcinoma and invasive lobular carcinoma, based on how they look under the m...

What Does It Mean If My Report Mentions E-Cadherin?

E-cadherin is a test that the pathologist might use to help determine if the tumor is ductal or lobular. (The cells in invasive lobular carcinomas...

What Does It Mean If My Carcinoma Is Well Differentiated, Moderately Differentiated, Or Poorly Differentiated?

When looking at the cancer cells under the microscope, the pathologist looks for certain features that can help predict how likely the cancer is to...

What Is Histologic Grade Or Nottingham Grade Or Elston Grade?

These grades are similar to what is described in the question above about differentiation. Numbers are assigned to different features (gland format...

What Does It Mean If Ki-67 Is mentioned in My Report?

Ki-67 is a way to measure how fast the cancer cells are growing and dividing. High values (over 30%) for Ki-67 mean that many cells are dividing, s...

What Does It Mean If My Carcinoma Has Tubular, Mucinous, Cribriform, Or Micropapillary Features?

These are different types of invasive ductal carcinoma that can be identified under the microscope. 1. Tubular, mucinous, and cribriform carcinomas...

What Is Vascular, Lymphovascular, Or Angiolymphatic Invasion? What If My Report Mentions D2-40 (Podoplanin) Or Cd34?

If cancer cells are seen in small blood vessels or lymph vessels (lymphatics) under the microscope, it is called vascular, angiolymphatic, or lymph...

What Is The Significance of The Reported Size of The Tumor?

If the entire tumor or area of cancer is removed, the pathologist will say how big the area of cancer is by measuring how long it is across (in gre...

What is a pathology report?

Stages of Cancer . A pathology report is a medical document that gives information about a diagnosis, such as cancer. To test for the disease, a sample of your suspicious tissue is sent to a lab. A doctor called a pathologist studies it under a microscope. They may also do tests to get more information.

What is the margin of a tumor?

Tumor margin: For the pathology sample, your surgeon took out an extra area of normal tissue that surrounds the tumor. This is called the margin. The pathologist will study this area to see if it’s free of cancer cells. There are three possible results:

What does grade mean in cancer?

Grade: The pathologist compares the cancer cells to healthy cells. There are different scales for specific cancers. A tumor grade reflects how likely it is to grow and spread. In general, this is what those grades mean: Grade 1: Low grade, or well-differentiated: The cells look a little different than regular cells.

What is the pathologist's job?

Microscopic description: The pathologist slices the tissue into thin layers, puts them on slides, stains them with dye, and takes a detailed look with a microscope. The pathologist notes what the cancer cells look like, how they compare to normal cells, and whether they’ve spread into nearby tissue.

How to grade a tumor?

Grade: The pathologist compares the cancer cells to healthy cells. There are different scales for specific cancers. A tumor grade reflects how likely it is to grow and spread. In general, this is what those grades mean: 1 Grade 1: Low grade, or well-differentiated: The cells look a little different than regular cells. They aren’t growing quickly. 2 Grade 2: Moderate grade, or moderately differentiated: They don’t look like normal cells. They’re growing faster than normal. 3 Grade 3: High grade, or poorly differentiated: The cells look very different than normal cells. They’re growing or spreading fast.

What is the identifying information on a blood test?

Identifying information: This has your name, birth date, and medical record number. It also lists contact information for your doctor, the pathologist and lab where the sample was tested.

What is the mitotic rate of cancer?

They’re positive if they have cancer and negative if they don’t. Mitotic rate: This is a measure of how quickly cancerous cells are dividing. To get this number, the pathologist usually counts the number of dividing cells in a certain amount of tissue. The mitotic rate is often used to find what stage the cancer is in.

Why is the pathology report for a biopsy different from a later report for the entire tumor?

This happens because the features of a tumor can sometimes vary in different areas. Your doctor will consider all of the reports to develop a treatment plan specific to you.

What is a pathology report?

Reading a Pathology Report. A pathology report is a medical document written by a pathologist. A pathologist is a doctor who diagnoses disease by: The report gives a diagnosis based on the pathologist’s examination of a sample of tissue taken from the patient’s tumor. This sample of tissue, called a specimen, is removed during a biopsy.

What does it mean when a pathologist tests a tumor?

A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A noncancerous, or benign tumor, means the tumor can grow but will not spread.

What is a positive lymph node?

Lymph nodes are tiny, bean-shaped organs that help fight disease. A lymph node is called “positive” when it contains cancer and “negative” when it does not. A tumor that has grown into blood or lymph vessels is more likely to have spread elsewhere. If the pathologist sees this, he or she will include it in the report.

What is a low grade tumor?

Tumors with fewer dividing cells are usually low grade. Tumor margin. Another important factor is whether there are cancer cells at the margins, or edges, of the biopsy sample. A “positive” or “involved” margin means there are cancer cells in the margin.

What does it mean when a tumor is noncancerous?

A noncancerous, or benign tumor, means the tumor can grow but will not spread. Other specific details about the tumor’s features. This information helps your doctor figure out the best treatment options. Your doctor will receive these test results as they become available.

What is a biopsy report?

The report gives a diagnosis based on the pathologist’s examination of a sample of tissue taken from the patient’s tumor. This sample of tissue, called a specimen, is removed during a biopsy. Learn about the various types of biopsies.

What is a pathologist's report?

When your breast was biopsied, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist. The pathology report tells your treating doctor the diagnosis in each of the samples to help manage your care. This FAQsheet is designed to help you understand the medical language used in the pathology report.

What does it mean when a pathologist coats the outer part of the specimen with ink?

If carcinoma extends to the ink, it indicates that it may not have been completely removed. The management of "invasive carcinoma", "intraductal carcinoma" (pre-cancer), "in-situ lobular carcinoma" (pre-cancer), "atypical duct hyperplasia" (early pre-cancer), or "atypical lobular hyperplasia (early pre-cancer)" at a margin is best discussed with your treating physician.

What are the different types of ductal carcinoma?

These are different types of ductal carcinoma. Tubular, mucinous, and cribriform carcinomas are types of well-differentiated cancers with typically a better prognosis. Micropapillary carcinomas are associated with a worse prognosis. However, a definite diagnosis of these types of cancer cannot be established on needle biopsy, since some tumors may have mixed features. Only if most of the tumor shows these features, which can only be done once the entire tumor is removed on lumpectomy or mastectomy, can these types of cancer be definitively diagnosed.

What are the two major patterns of breast cancer?

The two major patterns seen in breast carcinoma are ductal carcinoma or lobular carcinoma. In some cases, the tumor can have features of both and are called mixed ductal and lobular carcinoma. In general, there is not a significant different prognosis between invasive lobular and invasive ductal adenocarcinoma of the breast.

What is vascular invasion?

Tumors cells can break into small vessels seen under the microscope which is called "vascular" or "lymphovascular invasion". The presence of tumor in vessels is associated with an increased risk that the tumor has spread outside the breast, although this does not always occur. D2-40 and CD34 are special tests that the pathologist may do to help identify vascular invasion. These tests are not necessary in every case. If your report does not mention vascular or lymphovascular invasion, it means it is not present. Even with vascular invasion your cancer could still be very curable depending on other factors. How this finding will affect your specific treatment is best discussed with your treating doctor.

What does it mean when a report does not mention E-cadherin?

If your report does not mention E-cadherin, it means that this test was not necessary to make the distinction. 5.

What is adenocarcinoma in pathology?

1. What is "carcinoma" or "adenocarcinoma"? Breast carcinoma or adenocarcinoma is synonymous with breast cancer which is malignant, although can be curable when caught early.

How do pathologists look at cancer cells?

When looking at the cancer cells under the microscope, the pathologist looks for certain features that can help predict how likely the cancer is to grow and spread. These features include the arrangement of the cells in relation to each other, whether they form tubules (gland formation), how closely they resemble normal breast cells (nuclear grade), and how many of the cancer cells are in the process of dividing (mitotic count). These features taken together determine how differentiated the cancer is (and its grade – see below).

What is a pathologist report?

When your breast was biopsied, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist. The pathologist sends your doctor a report that gives a diagnosis for each sample taken.

What are the two types of breast cancer?

Breast carcinomas are often divided into 2 main types: invasive ductal carcinoma and invasive lobular carcinoma, based on how they look under the microscope. In some cases, the tumor can have features of both and is called a mixed ductal and lobular carcinoma.

What is the term for a cancer that starts in the lining layer of the breast?

Carcinoma is a term used to describe a cancer that begins in the lining layer (epithelial cells) of organs like the breast. Nearly all breast cancers are carcinomas. Most are the type of carcinoma that starts in glandular tissue, which are called adenocarcinomas.

When should hormone receptors be tested for breast cancer?

All breast cancers and pre-cancers, with the exception of lobular carcinoma in situ (LCIS), should be tested for these hormone receptors when they have the breast biopsy or surgery.

Where does breast cancer go?

If breast cancer spreads, it often goes first to the nearby lymph nodes under the arm (called axillary lymph nodes ). If any of your underarm lymph nodes were enlarged (found either by physical exam or with an imaging test like ultrasound or mammogram), they may be biopsied at the same time as your breast tumor. One way to do this is by using a needle to get a sample of cells from the lymph node. The cells will be checked to see if they contain cancer and if so, whether the cancer is ductal or lobular carcinoma.

Where does invasive ductal carcinoma come from?

Both invasive ductal carcinomas and invasive lobular carcinomas arise from the cells lining the ducts and lobules in the breast. In general, invasive lobular and invasive ductal carcinomas of the breast aren’t treated differently.

What are the terms on a breast pathology report?

Learn about the possible terms you might see on a breast pathology report, including breast carcinoma (cancer),  lobular carcinoma (LCIS), ductal carcinoma (DCIS),  atypical hyperplasia, and various benign breast conditions.

What is a lung pathology report?

A lung pathology report may include information about findings that are not cancer, such as granulomas, scarring, or inflammation. If cancer is found, it may also describe a type of cancer using specific terms. Learn how to interpret your lung pathology report here.

What is the American Cancer Society?

At the American Cancer Society, we’re on a mission to free the world from cancer. Until we do, we’ll be funding and conducting research, sharing expert information, supporting patients, and spreading the word about prevention. All so you can live longer — and better.

What is the role of a pathologist in cancer?

The pathologist is a medical doctor specializing in diagnosing disease by examining organs, tissues, cells and bodily fluids.

What are the observations of a gross examination?

Observations noted in the gross examination include the sample’s appearance and characteristics, such as size (typically documented in centimeters), texture (whether it is hard or soft, smooth or lumpy) and color. Gross examinations help determine accurate diagnoses because certain tumors have specific characteristics.

What is the procedure called when a patient's tissue is removed?

Many standardized procedures are performed before a diagnosis can be rendered. After the patient’s tissue sample is collected during either a biopsy or excision (the surgical removal of tissue), the pathologist conducts what’s known as a gross examination, performed with the naked eye, rather than under a microscope.

What is a tumor that lines a surface such as the skin or the GI tract called?

Tan. “A tumor that lines a surface, such as the skin or the GI tract, is carcinoma ,” he explains. “If the tumor originates from soft tissue like muscle, it’s sarcoma.

Why is it important to know what type of cancer is a tumor?

Identifying tumor type is key because tumors behave differently. “A treatment for lymphoma won’t work on a carcinoma,” says Dr. Tan. “Sarcoma usually doesn’t metastasize to lymph nodes, but carcinoma often does, and that’s important. One type of cancer requires a lymph node dissection, and another doesn’t.” And some tumor types, such as breast and lung cancers, require additional analysis because they may benefit from targeted therapies. Hormonal markers in breast tumors help identify which drugs may have the greatest impact, for example. “A breast cancer patient with an estrogen receptor-positive tumor typically gets tamoxifen, but a patient whose cancer is HER2-positive would get trastuzumab (Herceptin ® ), and if none of the slides show hormonal markers, the patient will typically get chemotherapy,” says Dr. Tan.

What does stage 0 mean in cancer?

Once the pathologist has examined all the tissue samples macroscopically (with the naked eye) and microscopically, and has graded them, he or she stages the cancer, assigning it a number from 0 (zero) to IV, with stage 0 indicating the cancer has not spread from its original location and stage IV indicating advanced disease.

Why are sectioned samples preserved?

The sectioned samples are preserved for future testing, which may be necessary if medical advancements lead to the discovery of a new tumor marker or a new treatment, for example, or if a duplicate slide is needed for the patient to use in seeking a second opinion.

What is a pathology report?

The pathology report tells your physician the diagnosis in each of your samples, and helps to manage your care. This FAQ sheet is designed to help you understand the medical language used in the pathology report. If your doctor says that you have cancer in your esophagus, it means that a pathologist, looking at the tissue samples your doctor took, ...

What is the pathology report for esophagus?

The pathology report tells your physician the diagnosis in each of your samples, and helps to manage your care. This FAQ sheet is designed to help you understand the medical language used in the pathology report. If your doctor says that you have cancer in your esophagus, it means that a pathologist, looking at the tissue samples your doctor took, found cancer in the tissue. A cancer diagnosis means that you have a tumor that is able to spread to other parts of your body.

What is the lining of the esophagus called?

The lining of the esophagus and stomach is known as the "mucosa." Most of the esophagus is lined by a tough covering called "squamous mucosa." Squamous mucosa is made up of many layers of flat cells that are similar to skin cells, but are on the inside of the esophagus. Goblet cells make up part of the normal lining in the intestines, but not in the esophagus. When goblet cells develop in a place where they are not supposed to be, this is called "intestinal metaplasia." When intestinal metaplasia occurs in the esophagus, it is called "Barrett's esophagus" Adenocarcinomas can start in Barrett's Esophagus or they can start in the part of the stomach just next to the esophagus. Squamous carcinomas arise from the squamous lining (mucosa) of the esophagus. In most cases of squamous carcinoma, the squamous lining is abnormal where the cancer starts.

What is squamous carcinoma?

Squamous carcinoma of the esophagus is a type of cancer (tumor) whose cells resemble the cells that make up the normal lining of the esophagus (see FAQ#3). Squamous carcinoma usually arises in a setting of smoking, prior injury to the esophagus from radiation, chemical ulceration, or alcohol abuse. Squamous carcinoma is not associated ...

Where does intestinal metaplasia start?

When intestinal metaplasia occurs in the esophagus, it is called "Barrett's esophagus" Adenocarcinomas can start in Barrett's Esophagus or they can start in the part of the stomach just next to the esophagus. Squamous carcinomas arise from the squamous lining (mucosa) of the esophagus. In most cases of squamous carcinoma, ...

What does it mean when a doctor says you have cancer in your esophagus?

If your doctor says that you have cancer in your esophagus, it means that a pathologist, looking at the tissue samples your doctor took, found cancer in the tissue. A cancer diagnosis means that you have a tumor that is able to spread to other parts of your body. 1. What if my report says "adenocarcinoma"?

What is the grade of cancer?

Grade is one of the many factors that helps determine how aggressive a given cancer is. Poorly differentiated cancers tend to be more aggressive. However, other factors in addition to grade, such as how far the cancer has spread (which cannot be determined on the biopsy) also affect the prognosis (how likely a person will survive the cancer).

What is a pathologist?

A pathologist is a doctor who diagnoses diseases by looking at tissue from the body. Samples of your melanoma tissue, removed during surgery or biopsy, will be sent to them for review. The pathology report is a result of their findings. This report contains important information about the tumor which is used to make treatment decisions.

What is the term for the death of cells in the center of a melanoma?

Ulceration is thought to reflect rapid tumor growth, which leads to the death of cells in the center of the melanoma. Regression: Regression is described as being present or absent. If it is present, the extent of regression is identified.

What is the VGP phase of melanoma?

Vertical Growth Phase (VGP): The melanoma is described as having VGP present or absent. If present, it is an indication that the melanoma is growing vertically or deeper into the tissues. VGP melanomas are invasive and have a potential to metastasize (spread to other areas).

What is the radial growth phase of melanoma?

If present, RGP indicates that the melanoma is growing horizontally or radially within a single plane of skin layer, meaning it is growing outward (horizontally), across the skin.

What is the sloughing of dead tissue?

Ulceration: Ulceration is the sloughing of dead tissue. This can sometimes occur in the center of a melanoma lesion. The presence of ulceration is incorporated into the staging classification of a melanoma. Ulceration is thought to reflect rapid tumor growth, which leads to the death of cells in the center of the melanoma.

What does it mean when a blood vessel invades the lymphatic system?

If present, it means that the melanoma cells have invaded the blood or lymph system.

What is a tumor-infiltrating lymphocyte?

Tumor-Infiltrating Lymphocytes (TILs): TILs describe the patient's immune response to the melanoma. When the pathologist examines the melanoma under the microscope, he/she looks for the number of lymphocytes (white blood cells) within the lesion. This response, or TILs, is usually described as "brisk", "non-brisk", or "absent", although occasionally as "mild" or "moderate". TILs indicate the immune system's ability to recognize the melanoma cells as abnormal.