What is pathology?
Pathology relates to the branch of medicine that looks at how disease affects the body’s cells and tissues. Tissue is looked at under a microscope and may have tests performed on it. The results are given in a pathology report.
Why are pathology results important in breast cancer?
If you have a biopsy or tissue removed during breast surgery, this is examined by a pathologist. Through various tests the pathology results can tell you:
- the type of breast cancer
- the size of the breast cancer
- the grade of the breast cancer (how different the breast cancer cells are to normal cells and how quickly they are growing)
- if the breast cancer has been completely removed (if there is a clear margin of healthy tissue around it)
- if the breast cancer has broken through the networks of lymph and blood vessels (lympho-vascular invasion)
- if there are any breast cancer cells in the lymph nodes under the arm
- if the breast cancer is oestrogen receptor positive (ER+)
- if the breast cancer is HER2 positive
What the different results can mean?
If someone has grade 3 breast cancer which means the breast cancer cells look least like normal cells and are growing quickly, that person is more likely to be offered chemotherapy to help destroy any cancer cells that may have spread.
Someone who has hormone receptor negative breast cancer (so their breast cancer isn’t stimulated to grow by oestrogen) won’t be recommended hormone therapy as it would have no effect. So taking something like tamoxifen would be of no benefit.
A clear margin of healthy tissue around the breast cancer means that further surgery can be avoided.
Some people will also have tests to look at groups of genes found in the breast cancer. These are known as gene assays. They help identify who is most likely to benefit from chemotherapy and how likely the cancer is to return (recurrence). The results will be considered alongside other pathology results to help decide what treatments to recommend. The Oncotype DX test is probably the most widely known of these sorts of tests.
The right treatment for you
All this information is used to make decisions about the best treatment. Other matters are also then taken into consideration like your overall health, any other health conditions you have and your personal preferences.
When someone with breast cancer wonders why their treatment differs to someone else with the same type of breast cancer as them, it can be down to their individual pathology results.