Newswise — An estimated 1 in 8 women will be diagnosed with invasive breast cancer at some point in their lifetime, according to the American Cancer Society. In light of October’s observance of National Breast Cancer Awareness Month, Jean F. Simpson, MD, FCAP, provides insight into both the patient’s and pathologist’s role in treating breast cancer. Dr. Simpson chairs the College of American Pathologist’s (CAP) Cancer committee and is a breast pathologist in Nashville, Tennessee.
“Effective treatment begins with an accurate diagnosis—without that, the care team will not know the best course of treatment for the patient, which depends on the type of cancer and extent of disease,” said Dr. Simpson. “Patients may not always be in direct contact with their pathologist, but that doesn’t mean they cannot become a more knowledgeable patient.”
If you find yourself facing a breast cancer diagnosis, Dr. Simpson recommends the following steps to help improve your understanding of the treatment process.
•Request your pathology report: A copy of your pathology report is available and will specifically outline your diagnosis, which steers the course of your treatment.
•Understand your diagnosis: Resources like the CAP's Understanding Your Pathology Report can teach non-medical professionals how to read the report, and includes important details like whether a tumor is benign or cancerous and, if cancerous, the type, grade, and extent of the cancer. You can also ask to speak to your pathologist if you have any questions regarding your report or diagnosis.
•Explore your diagnosis: The diagnosis of most breast cancers is straightforward, but some examples of non-invasive cancers (e.g., ductal carcinoma in situ), can be difficult to diagnose, especially in a core biopsy specimen that may sample only a small amount of the abnormal area. The lay press has highlighted the difficulty in consistent diagnosis of these borderline lesions, as pointed out in a recent Wall Street Journal article .
To understand their diagnosis, patients might consider asking their treating physicians the following questions:
o Is my diagnosis an invasive or non-invasive type of cancer?
o Do the imaging and pathology report match?
o Was enough of my tumor sampled for it to be diagnosed?
o Did the biopsy come from the same targeted area represented in the imaging?
•Understand your options: Women diagnosed with breast cancer should not rush into treatment. They have time to consider options based on the expertise of their care team, including further tests and even second opinions. Pathologists follow several processes to try to ensure accuracy in their diagnoses. This includes the integration of patients’ clinical information, including imaging findings. The pathologist may use special stains to help sort out the findings under the microscope. Decisions are rarely if ever made in isolation, however, as collaboration and consultation with other pathologists and clinicians is regular practice. The patient also needs to have a voice in their own care process, according to Dr. Simpson.
“There are often multiple treatment options even when we’ve made a clear diagnosis,” said Dr. Simpson. “It really assists the care team in planning and prescribing treatment when the patient is informed, involved, and able to make choices.”
About the College of American PathologistsAs the leading organization with more than 18,000 board-certified pathologists, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. The CAP’s Laboratory Improvement Programs, initiated 65 years ago, currently has customers in more than 100 countries, accrediting 7,700 laboratories and providing proficiency testing to 20,000 laboratories worldwide. Find more information about the CAP at cap.org. Follow CAP on Twitter: @pathologists.