Understanding Your Pathology Report

A pathology report describes the tissue sample taken during a biopsy or surgery, including where it came from, what type of cells are present, and whether they are cancerous. It typically includes a diagnosis, the tumour's grade, its size, whether surgical margins are clear of cancer, and results of any special stains such as immunohistochemistry, often abbreviated IHC. Additional molecular or genetic testing results may also be included or attached separately.

Reviewing your pathology report with your doctor can help you understand exactly what type of cancer you have and why specific treatments are being recommended. It can feel technical, so it is reasonable to ask your care team to walk through each section and explain any terms that are unclear.

A pathology report itself does not describe symptoms; rather, it explains the biological features of tissue that was already removed because of a suspicious finding, symptom, or screening result. Any symptoms that prompted the original biopsy would typically be documented elsewhere in your medical record.

The report is generated after a pathologist examines tissue obtained from a biopsy or surgery, using microscopic examination along with special stains and, when relevant, molecular testing. The final diagnosis section typically states the specific type of cancer, its grade, and other relevant features.

In addition to standard microscopic examination, testing may include immunohistochemistry to identify specific proteins, and molecular or genetic testing to detect mutations, gene rearrangements, or other biomarkers relevant to treatment selection.

The structure of a pathology report is similar across cancer types, though the specific details recorded vary; for example, breast cancer reports typically include hormone receptor and HER2 status, while colorectal cancer reports may include information on mismatch repair or microsatellite instability status. Your report will reflect the specific tests relevant to your cancer type.

Findings in the report can influence whether additional surgery is needed to achieve clear margins, whether radiation or systemic therapy is recommended after surgery, and which specific systemic therapies, such as targeted treatments or hormone therapy, are likely to be effective based on biomarker results.