Lung Cancer

Your Pathology Report

Your pathology report is a document that provides the results of tests to diagnose your lung cancer. It includes specific information about your cancer, which helps your oncologist and other members of your medical team plan the treatment most likely to be effective for your lung cancer.

Pathology reports look different at different cancer centers and hospitals, but most include the same information. The details and unfamiliar terms may seem overwhelming at first, but once you learn what the words mean, you’ll be more informed about your diagnosis and better able to discuss your treatment options with your doctor.

A pathologist is a doctor who diagnoses disease based on the evaluation of biopsy samples and the results of other tests. It’s best for the pathologist to be experienced in lung cancer. To diagnose lung cancer, the pathologist carefully examines tissue taken during a biopsy. In some cases, the pathologist may examine an entire tumor removed in surgery. The pathologist will note how the cells of the tissue look through a microscope, which defines the histologic type of the cancer. After examining the sample, the pathologist writes the pathology report. Your doctor will receive your test results as they become available, but it may take a few days to a few weeks to receive the full report.

The pathology report describes the tissue sample and may include the results of other testing (see Table 1). For example, testing for biomarkers is now recommended for most cases of non-small cell lung cancer. The results of biomarker testing are important because they can help guide treatment decisions.

If the pathologist cannot determine the histologic type, an expert pathologist and special studies may be required or another biopsy may be needed. Seeking a second opinion from another pathologist can be beneficial. Seek another opinion if the pathology report does not include a definitive diagnosis, if you have a rare lung cancer or if the cancer has already spread. A second opinion could confirm your diagnosis or suggest an alternative diagnosis.

The pathology report also includes the stage of your lung cancer. Learn more about how lung cancer is staged here. For more information about a typical pathology report, including definitions of the terms commonly used by the pathologist, see the additional resources below.

Table 1. Important components of a lung cancer pathology report

Descriptor What is described or measured Significance
Size Length and width of the tumor.  
Location The lung (right or left) and lobe in which the tumor is found.  
Histology The histologic type: small cell or non-small cell by type (adenocarcinoma, squamous cell lung cancer or large cell cancer), or a rare subtype. Treatment varies according to histologic type.
Surgical margins Presence or absence of cancer cells in the normal tissue at the edges of the tumor. Additional surgery or radiation therapy may be needed if the margins are close or positive.
Extent of invasion The structures affected by the tumor. Extent of invasion is a factor in staging and a consideration when selecting treatment, including determining whether a tumor is operable (can be removed safely with an operation).
Lymph node status Presence (positive) or absence (negative) of cancer cells in the nearby lymph nodes. Negative lymph node status generally means a less extensive cancer; lymph node status is another primary factor in staging.
Biomarker testing Presence or absence of molecular changes in the tumor tissue. (See Treatment for more information about these abnormalities.) If your tumor has a molecular abnormality, it may respond to targeted therapy.

Questions to ask your medical team

  • May I have a copy of my pathology report?
  • Do I need to share my pathology report with my primary care doctor?
  • What is the exact type of lung cancer I have?
  • What is the stage of my lung cancer and what does it mean for me?
  • What are my treatment options?
  • Will I need more tests before we decide which treatment to use?
  • Has the cancer spread to my lymph nodes or other organs?
  • Would testing for genetic abnormalities be helpful?
  • What is my prognosis?

Additional Resources

 

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