Sandra Lee, the girlfriend of the Governor of New York, Andrew M. Cuomo, recently announced she received a ductal carcinoma in situ (DCIS) diagnosis. As a result, she decided to undergo a double mastectomy. Receiving a breast cancer diagnosis is frightening, as she noted in a recent news release, “I was stunned.”

Jean F. Simpson, MD, FCAP who is a breast pathologist, as well as chair of the College of American Pathologists Cancer Committee is currently on a media campaign discussing key points of breast cancer diagnosis, including:

• The diagnosis of DCIS;
• The questions that patients should ask their doctors;
• The process of informed treatment decision.

“Effective breast cancer treatment means having the right diagnosis. The pathology report gives the entire care team a road map,” Dr. Simpson said in a recent news release. “Pathologists are highly trained experts, who interpret laboratory test results and work collaboratively to establish the diagnosis, but their work happens behind the scenes and they may not meet patients. Women can work with their primary care providers to better understand their pathology report and diagnosis.”

According to CAP and Dr. Simpson, if a women receives a breast cancer diagnosis she should:

• Ask for a copy of the pathology report;
• Look at resources such as CAP’s Understanding Your Pathology Report to understand their pathology;
• The majority of breast cancers are easy to diagnose, but some, like non-invasive cancers, can be difficult to diagnose.
• • In this regard patients should consider asking if the imaging provided by the radiologist is characteristic of their diagnosis;
  • Patients should also understand if the imaging and pathology report match;
  • How confident is the pathologist that the tissue sample from the biopsy represents the targeted area shown in imaging;
  • if there was enough tumor sample removed for it to be accurately diagnosed;

• If the diagnosis is of an invasive or non-invasive type of cancer.

The pathology report is an important tool for women to decide about their treatment options. For diagnostic accuracy and quality, pathologists follow a procedure that requires a detailed look at patients’ information; carefully analyzing areas of diagnostic concern. They also often collaborate with other clinicians to make diagnostic decisions. By following this process, women can make suitable treatment choices.

“Even when diagnosis is clear, women often have multiple treatment options,” said Dr. Simpson in the news release. “When women are familiar with their pathology report, they are in a better position to explore treatment choices that fit their personal needs. The ‘X-factor’ in good outcomes can often be a patient who gets all the facts of her case and fully engages with the care team.”