The role of the pathologist in breast cancer management

The pathologist is a consultant in breast cancer patient management whose first responsibility is to establish the histologic diagnosis of cancer as well as its anatomic extent when sufficient tissue has been provided. The consultation also provides data that may be used to aid in selecting primary or adjuvant therapy, evaluating new therapies, estimating prognosis and assessing outcome. Examples of such data are the TNM histopathologic classification of the anatomic extent of the cancer used for the stage grouping (T: the extent of the primary tumor; N: the absence or presence and extent of regional lymph node metastasis; M: the absence or presence of distant metastasis), size, histologic type, histologic and/or nuclear grade, blood vessel and lymphatic vessel invasion assessment, steroid receptor analysis, and other special studies as appropriate.