Pathologist Questions Pathologist

How do you read a pathology report for prostate cancer?

I am a 48 year old male. I want to know how do you read a pathology report for prostate cancer?

5 Answers

Before even the pathology of biopsies from prostates are read, each biopsy is identified by location as received from the Urologist directly from the operating room. They are labeled as right superior, right middle, right lower, left superior, left middle and left lower biopsies. I describe each biopsy by length and thickness and submit them for paraffin processing overnight. The next day the technician (Pathology Technician), slice the paraffin block to obtain a slim size cut and put it in a glass slide for the staining process before it is read. The staining lasts another day since it is done overnight. When I receive the slides, I look at them in the microscope and the start reading the cells. I look for normalcy of the cells by shape, size, differentiation, nuclear/cytoplasmic ratio (meaning the rate of nucleal material versus the cytoplasm), shape of the nuclear membrane, nuclear density and how different is from a normal prostate cell. The pathologist gives each core a number in the pathology report, and each core will get its own diagnosis. We give what is called a Gleason Score or grade. It is the predominant pattern in your biopsy and a second predominant Gleason grade pattern. Gleason range from 2-10. However, since 2-5 almost never assign scores. Gleason scores range from 6-10. The risk group are as follow; low/very low grade is less than 6. Equals to group 1. Intermediate (favorable or unfavorable) is 7. (3+4) or (4+3) respectively. High/ Very high, grade 4 Gleason 8, and group 5, Gleason 9-10. The diagnosis also includes the clinical stage. Thank you.
I read the report of pathology from a biopsy of the prostate. The pathology will show how aggressive of tumor is (Gleason score from 2 to 10)how much the gland is involved, whether it extends outside the prostate gland or to seminal vesicles, any lymphatic air vascular involvement, or perineural invasion to the stage of the disease). This information will guide me to recommend what kind of treatments for patients.
The diagnosis in a pathology report should be interpreted by your physician. Without medical training many of the words and phrases used in the report are difficult or impossible to interpret.
Pathology report for prostate biopsy should say the diagnosis. If there is cancer in the specimen, then it will usually say adenocarcinoma. There should be a grade listed too. Higher grade means worst cancer. Sometimes report may include percent of prostate tissue involved by cancer. If there is no cancer, then the report will read benign prostate tissue or prostatic hyperplasia or prostatitis or no evidence of malignancy.
Hello, Pathology reports from prostate biopsies are difficult to interpret. In general a physician familiar with the treatment and diagnosis of prostate cancer needs to carefully read the report prior to making treatment recommendations.

My suggestion would be to consult the guidelines published by the National Comprehensive Cancer network (NCCN.org). These guidelines are updated at least annually and more often as needed.

My suspicion is that your physician was performing screening Prostate Specific Antigen (PSA) testing and that you had a prostate biopsy. The guidelines subdivide patients with prostate cancer into several groups and make treatment decisions based on tumor characteristics and the subgroup into which one falls. The pathology report is necessary to make these risk group determinations. Further molecular characterization can then be carried out if necessary.

It is recommended that your physician be consulted and questions about the pathology be asked of that person. Good luck.