CAP pathologist shares four tips for women with breast cancer

For any woman, a diagnosis of breast cancer can be frightening. But as Rita Wilson's recent experience shows, engaging with the keystone of the diagnosis - the pathology report - can be critical in achieving good outcomes. Informed by rigorous scientific processes, training and team discussion, pathology reports identify a diagnosis, help indicate the right providers for a patient's care team and shape treatment plans.

"Effective breast cancer treatment means having the right diagnosis. The pathology report gives the entire care team a road map," said Jean F. Simpson, MD, FCAP, chair of the College of American Pathologists (CAP) Cancer Committee and breast pathologist. "Pathologists are highly trained experts who interpret laboratory test results and work collaboratively to establish the diagnosis, but their work happens behind the scenes and they may not meet patients. Women can work with their primary care providers to better understand their pathology report and diagnosis."

So, what should women do if they receive a breast cancer diagnosis? Dr. Simpson and the CAP shared the following tips:

•Get your pathology report: Ask for a copy of your pathology report and remember that it may be just a few clicks away. While many practices share hard copies, a growing number are offering password-protected patient portals.

•Understand what it means: Women don't need to become physicians overnight to develop a basic understanding of what their pathology report means. Resources like Understanding Your Pathology Report can provide important tips on how to understand the information within the report, including whether a tumor is benign or cancerous and, if cancerous, the exact type, grade, and stage of the tumor.

•Explore the path to diagnosis: Most breast cancer pathology results are straightforward, but some fall into a 'grey zone' that cue pathologists to get extra input. Most breast cancers are clear to diagnose, but some, like non-invasive cancers, can be subtle and complex to diagnose. Questions a patient might ask include:
o Is the imaging provided by my radiologist characteristic of my diagnosis? Do the imaging and pathology report match?
o How confident is my pathologist that the tissue sample from my biopsy represents the targeted area shown in imaging?
o Was enough of my tumor sampled for it to be fully understood and reliably diagnosed?
o Is my diagnosis an invasive or non-invasive type of cancer?

•Understand your options: The pathology report is a tool to mapping next steps. Women diagnosed with breast cancer have time to consider options with their care team, including further tests.

Every woman should feel confident in the processes that lead up to diagnosis. To ensure the quality and accuracy of their diagnoses, pathologists follow a process which includes integration of patients' clinical information, including imaging findings; other steps may include examining additional levels or sections from an area of diagnostic concern, using special staining techniques to gain additional information, collaboration with other pathologists in their practice, or consultation with an outside pathologist with special expertise. By engaging with the results of this process, women can gain valuable information that leads to good treatment decisions.

"Even when diagnosis is clear, women often have multiple treatment options," said Dr. Simpson. "When women are familiar with their pathology report, they are in a better position to explore treatment choices that fit their personal needs. The 'X-factor' in good outcomes can often be a patient who gets all the facts of her case and fully engages with the care team."

Source: College of American Pathologists