Understanding Your Pathology Results
Making Sense of Your Diagnosis
Receiving a pathology report can feel confusing and emotional. The medical terms and numbers may seem overwhelming, but each detail helps your doctors understand what’s happening and how best to treat it.
At Breast & Wellness, our goal is to help you understand your results clearly and calmly.
We take time to explain every finding — what it means, how it guides your treatment, and what the next steps will be.
What Is Pathology?
Pathology is the study of tissue and cells under a microscope.
When a core biopsy or fine-needle sample is taken from your breast, it’s examined by a pathologist — a doctor who looks for any abnormal or cancerous cells.
This report forms the foundation of your treatment plan. It tells your team:
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Whether the tissue is benign (non-cancerous) or malignant (cancerous)
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The type and characteristics of the cells
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How quickly the cells are growing
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Which treatments are most likely to work
Key Details in a Breast Pathology Report
1. Diagnosis (Type of Breast Condition)
This describes what the pathologist found in your biopsy:
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Benign: non-cancerous changes like cysts or fibroadenomas.
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Pre-cancerous: changes such as ductal carcinoma in situ (DCIS), where abnormal cells are still confined within the ducts.
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Invasive cancer: cancer cells that have spread beyond the ducts or lobules into surrounding breast tissue.
2. Hormone Receptor Status (ER and PR)
These tests show whether the cancer cells are affected by the hormones oestrogen (ER) and progesterone (PR).
If these are positive, the cancer is likely to respond well to hormone-blocking (endocrine) therapy.
If negative, other treatments such as chemotherapy or targeted therapy may be more effective.
3. HER2 Status
HER2 is a protein that helps cells grow. Some cancers make too much HER2.
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HER2-positive: may respond very well to targeted therapies like Herceptin (trastuzumab).
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HER2-negative: treated with other therapies such as hormone or chemotherapy.
HER2 results are sometimes double-checked with an additional test called ISH if results are unclear.
4. Tumour Grade
Grade describes how abnormal the cancer cells look and how fast they may grow.
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Grade 1: Cells look close to normal and tend to grow slowly.
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Grade 2: Cells look somewhat different and grow at a moderate rate.
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Grade 3: Cells look very different and tend to grow faster.
5. Ki-67 (Proliferation Index)
This test measures how many cells are dividing.
A higher Ki-67 value means faster-growing cells.
This helps your doctors decide whether treatments like chemotherapy or targeted therapy may be useful.
How the Results Work Together
Each test gives one piece of information.
When combined, they help your doctor understand:
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What type of breast condition you have
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How it behaves
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Which treatments are most effective
No two breast cancers are identical, so your treatment plan is based entirely on your individual results, health background, and preferences.
Examples of Pathology Results and What They Mean
To help you understand how results are interpreted, here are some common examples.
Example 1: Hormone Receptor Positive (ER+ / PR+), HER2 Negative, Grade 2
“Your biopsy shows an oestrogen and progesterone receptor positive cancer that does not overproduce HER2. The cells are moderately active (Grade 2).”
This is one of the most common types of breast cancer.
It usually responds very well to hormone (endocrine) therapy, and treatment plans often include breast-conserving surgery and radiotherapy.
Chemotherapy may be recommended in some cases, depending on other risk factors.
Example 2: HER2 Positive, Grade 3, ER / PR Negative
“Your cancer cells produce higher levels of a protein called HER2, which helps them grow faster. Hormone receptors are not present, and the cells are quite active (Grade 3).”
This type tends to grow more quickly but responds extremely well to targeted therapies such as Herceptin (trastuzumab) or Pertuzumab.
These treatments are often combined with chemotherapy and radiotherapy to achieve excellent long-term control.
Example 3: Triple Negative (ER-, PR-, HER2-)
“Your cancer does not have hormone or HER2 receptors. The cells are moderately to highly active.”
This type is called triple-negative breast cancer.
While it can behave more aggressively, it often responds very well to chemotherapy and newer immunotherapytreatments.
Example 4: Ductal Carcinoma In Situ (DCIS)
“The abnormal cells are contained within the milk ducts and have not spread into surrounding tissue.”
DCIS is considered a non-invasive (early stage) breast cancer.
Treatment usually involves surgery (lumpectomy or mastectomy) and sometimes radiotherapy to prevent recurrence.
The prognosis is excellent, and cure rates are very high.
Example 5: Benign (Non-Cancerous) Changes
“The tissue sample shows no cancer cells — only normal or benign changes such as cysts or fibroadenoma.”
No cancer treatment is needed.
Your doctor may recommend routine imaging follow-up to monitor for future changes.
What These Examples Show
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Each pathology report is unique — no two are exactly alike.
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The combination of findings (ER, PR, HER2, grade, Ki-67) determines which treatments will be most effective.
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Even when results sound complicated, there are proven, effective treatments for every type of breast cancer.
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Your specialist will explain how your results fit together and what they mean for your next steps.