What is a biopsy report?
A biopsy report (pathology report) is written by a pathologist — a doctor who examines your tissue under a microscope. It answers three questions: is it cancer, what type is it, and how aggressive does it look? Every treatment decision that follows builds on this document.
The sections, decoded
- Specimen / gross description — what tissue was received and its size. Routine bookkeeping.
- Diagnosis — the headline: the cancer type (e.g. adenocarcinoma, carcinoma, lymphoma) and where it started.
- Grade — how abnormal the cells look, usually 1 to 3 (or “well” to “poorly differentiated”). Lower grade generally means slower-looking; higher grade, faster-looking. Grade is about appearance; stage (how far it has spread) is a separate thing.
- Margins — for surgical specimens: whether cancer reaches the edge of what was removed. “Negative/clear margins” means it does not.
- Immunohistochemistry (IHC) — stains that reveal which proteins the cells carry (for example HER2 or hormone receptors in breast cancer, CD20 in lymphoma). These markers often decide which drugs can work.
- Ki-67 or mitotic index — roughly, what fraction of cells are actively dividing. A higher number means faster growth.
What a biopsy report does NOT tell you
It usually does not tell you the stage, the prognosis, or the treatment plan — those come from combining it with scans, blood work and your overall health. A frightening word in the report is not a verdict; it is one input.
Frequently asked questions
Should I get a copy? Yes — always. It is your record, and any second opinion will need it.
What if two pathologists disagree? It happens, especially in rare cancers. A pathology review at a larger centre is a normal, respected request.
Can you explain mine? Yes — that is precisely what our helpdesk does. Attach the report to a ticket and we will translate it line by line.