Questions to Ask About Your Pathology Report

A pathology report describes tissue taken during a biopsy or surgery. It gives the definitive diagnosis your care team uses for staging and treatment planning. It usually includes a gross description (what the tissue looks like to the naked eye), a microscopic description (what it looks like under a microscope), and a final diagnosis. It may also include the tumor grade, margin status, lymph node status, and biomarker or molecular test results.

Reports often appear in a patient portal before your doctor can discuss them. That alone can be confusing or worrying. These prompts are adapted from facts the National Cancer Institute provides about pathology reports. They help you make sense of what you are looking at, and know what to ask.

• What type of cancer does my report show?
• What is the grade, and what does it mean?

Grade describes how abnormal the cancer cells look under a microscope. That can relate to how the cancer might behave.

• Were the margins clean, or was cancer found at the edge?
• Were any lymph nodes involved?
• Are biomarker or molecular tests being done, and will they add time before we plan treatment?

A "clean" or negative margin generally means no cancer cells were found at the edge of the removed tissue. A "positive" or involved margin means cancer cells were found there. Lymph node status, positive or negative, describes whether cancer was found in nearby lymph nodes.

• Can we go over the report together?
• Can I get a second-opinion review of my slides?

You or your doctor can request a second opinion on the pathology itself, separate from one on the treatment plan. Many institutions, including NCI-designated cancer centers, offer this kind of review.

Pathology reports are dense documents written for other doctors, not for patients. It is reasonable to:

• Ask for a copy of the full report to keep for your records.
• Ask your doctor to translate technical terms into plain language.
• Ask what in the report changes the treatment plan you had already discussed.

A pathology report can look intimidating. It is really a tool for planning your care, not a verdict to decode alone. Ask about the diagnosis, the grade, the margins, lymph nodes, and any biomarker testing. Ask your doctor to walk through it with you. That turns a dense document into information you can use.