How to read the breast pathology report?

  Breast cancer patients usually receive a pathology report about 10 days after surgery, which mainly reflects the specifics of the patient’s tumor, including: type of pathology, extent of invasion, and lymph node metastasis. These conditions can only be observed by the pathologist under a microscope or even using special methods after surgical resection. They can help the doctor to judge the patient’s prognosis and choose the treatment method, etc. Generally a complete post-operative pathology report of breast cancer should include the following contents: 1. Nature of tumor, specific pathological type For example: “invasive ductal carcinoma of the left breast” —- “cancer For example, “left breast invasive ductal carcinoma” “cancer” means malignant tumor, “invasive ductal carcinoma” is one of the more common types of breast cancer. Of course there are some other types.  2. The location and size of the tumor For example: “Outer upper, 3*2CM” —- This means the location and size of the lesion observed through the microscope, it may be the same as the lesion we feel by hand, but it may also be different. Because some people have tumors growing in multiple places in one breast at the same time, distributed in different locations, and the size of malignant tumors is often not in the range of what the doctor can see with his eyes or feel with his hands, and there may be growths in other places as well. Therefore, the location and size of the tumor on the pathology report may be a more realistic response to the situation of the tumor, which is of great significance to the doctor in choosing the treatment.  3. Invasion of blood vessels and lymphatic vessels or not Invasion of blood vessels and lymphatic vessels is related to the choice of adjuvant therapy or not.  4. Axillary lymph node metastasis This is another important indicator in the pathology report. “Left axillary lymph nodes 0/16 see cancer metastasis” —- means there is no more cancer metastasis in the 16 lymph nodes detected by the doctor. Generally speaking, the earliest site of breast cancer metastasis is the axillary lymph node. This report means that relatively speaking, the patient has an early stage of the disease and has not yet metastasized to the axilla, so there is less chance of recurrent metastasis later. This can guide the doctor to understand the patient’s condition properly, so as to formulate an appropriate treatment plan, such as whether chemotherapy, radiotherapy, etc. are needed.  5. Hormone receptor ER, PR, NEU These indicators are usually reported later than the above. ER and PR reflect whether the tumor needs endocrine therapy or not. If one of them is positive, it means the patient may be effective for endocrine therapy and have better effect using endocrine therapy. NEU, on the other hand, reflects the amplification of this gene of the tumor, if it is over-expressed, it can help the doctor choose to use some targeted drugs against this gene. They also reflect the chance of recurrence and metastasis in the future, and the effectiveness of certain therapeutic drugs.  In conclusion, the above information varies from person to person, and no single information can determine whether a patient is prone to recurrence and metastasis, needs radiotherapy, etc. It is up to the doctor to decide the specific treatment and drug selection.