Understanding Your Pathology Report

Living with relapsed refractory multiple myeloma (RRMM) can be scary and worrisome. The words used by your doctor may be confusing. The medical terms may not be familiar to you yet. To better understand what you have been told, it is important to understand your pathology report.

Pathology

Pathology is the study of the way a disease works. A pathologist is a doctor who studies samples of blood, body fluids, and tissue to diagnose a disease.¹

As part of a multiple myeloma diagnosis, your doctor will take samples and send these to a lab to analyze. This is called a specimen. Specimens are gathered with a biopsy, during surgery, or through a blood test or urine sample. They are then viewed under a microscope.¹

Many myeloma patients experience relapse (the cancer coming back) or the cancer becoming refractory (not responding to treatment). When someone has relapsed refractory multiple myeloma, a pathologist may work with their oncologist to form different treatment plans. These plans may be based on:²

• Previous treatments
• Relapse rate
• Overall health
• Genetic abnormalities of the cancer

What is a pathology report?

A pathology report gives you and your doctor important information about your cancer cells. This report is not written for the average consumer to understand. This is a technical report written by healthcare professionals for other healthcare professionals. However, you can still educate yourself about the information in your pathology report and understand the basics.¹

What is in a pathology report?

Standard information that all pathology reports generally include are:¹

Demographics

• Patient information
• Case number
• Doctor contact information
• Lab information
• Specimen information

Preoperative diagnosis

• What your doctor thought the diagnosis may be before your samples were examined

Procedure

• The type of procedure used to obtain the specimen samples

Gross description

• Things visible to the eye, such as weight, size, and color of tissues or bodily fluids

Microscopic description (the most technical section)

• Cell structure (histology): The kind of cancer identified
• Tumor margins: Whether or not there are cancer cells at the edge of a tissue sample
• Depth of invasion: Whether the tumor is invasive, metastatic, or noninvasive
• Pathologic stage: (T) Size and location of tumor, (N) whether it has spread to nearby lymph nodes, (M) whether the tumor has spread to other parts of the body
• Tumor grading: How cancer cells compare to normal healthy cells
• Special tests or markers
• Results of special tests performed in the lab to identify unique parts of these cells

Diagnosis

• Cancer type
• Pathologic staging results
• Other test results

Summary

• Details about the most important results, listed in a table. Also includes possible treatment options.

Comments

• Description of any concerns about the sample or recommendations for more tests

Pathologist signature

• The name, date, and signature of the pathologist reviewing the lab results

Ask for a copy of your report

Get a copy of the pathology report for your records. It may be hard to understand all of the medical language, but this report is an important part of your health history. Reviewing the report with your doctor will help you better understand your diagnosis and treatment options.

Keep in mind that a pathology report can be subjective and based on interpretation. Therefore a diagnosis is not always clear. It is okay to ask questions and seek a second opinion of the specimen sample.¹

Questions to ask your doctor

When talking to your doctor about your pathology results, consider some of these questions:²

• How does myeloma develop?
• What does relapsed refractory mean?
• Do I need more tests?
• What are my treatment options?
• What is my prognosis? Will I get better?
• How long is the treatment process?

Understanding your pathology report will help you be better informed and prepared for treating your relapsed refractory multiple myeloma.