Pathology

Pathology plays a central role in cancer diagnosis and treatment planning. By examining tissue, cells and molecular findings, pathologists help determine what a disease is, how it should be characterized and which information other specialists need to guide the next step in care.

Much of this work happens behind the scenes, but the pathology report may be one of the most important documents in a patient’s care. At Providence Saint John’s Health Center, pathologists work closely with surgeons, medical oncologists, radiation oncologists and other specialists across the Centers of Excellence to support diagnosis, staging and treatment planning.

From Biopsy to Diagnosis

When imaging, an examination or another test identifies an area of concern, a biopsy may be performed to obtain a small sample of tissue. That tissue is prepared in the laboratory and examined by a pathologist, who looks for changes in the cells and tissue that can help determine whether the finding is benign, precancerous, cancerous or related to another disease process.

The pathology report communicates those findings to the clinical team. Depending on the diagnosis, additional testing may be performed to further characterize the disease and provide information that can influence treatment decisions.

The Specialist Behind the Diagnosis

Most patients never meet their pathologist directly, but the pathologist works closely with the physicians who do. Surgical pathologists specialize in examining tissue removed during biopsy or surgery and provide diagnostic and staging information that helps other specialists understand the disease and plan care.

What the Pathologist Looks For

The specific findings depend on the type of tissue and condition being evaluated. A pathology report may describe the type of tumor, how the cells appear under the microscope, whether cancer is present at a surgical margin, whether lymph nodes contain cancer and other features that help characterize the disease.

For some cancers, additional laboratory or molecular testing may provide information about proteins, receptors, gene changes or other biomarkers that can help refine the diagnosis or guide treatment.

How Pathology Helps Guide Treatment

A diagnosis rarely stands alone. Pathology findings are considered together with imaging, physical examination, surgical findings, medical history and other clinical information when a treatment plan is developed.

Because different cancers require different information, the pathology team works with specialists across Saint John’s clinical programs. Pathologists also participate in multidisciplinary cancer conferences where pathology findings can be reviewed alongside imaging and other patient information.

Multidisciplinary Pathology Review

Pathology is closely integrated with multidisciplinary cancer care at Providence Saint John’s Health Center. Pathologists routinely review and present findings at cancer conferences involving specialties such as breast, thoracic, gastrointestinal, genitourinary, skin and neuroscience.

This collaboration gives surgeons, medical oncologists, radiation oncologists, radiologists and other specialists an opportunity to evaluate the pathology findings together with imaging and clinical information before treatment decisions are finalized.

Molecular & Specialized Testing

Modern pathology extends beyond what can be seen under a microscope. Depending on the type of cancer and clinical question, tissue may undergo immunohistochemical, molecular or genetic testing to identify characteristics that can help classify the tumor, clarify prognosis or guide treatment.

Not every patient requires the same tests. The type and extent of testing depend on the diagnosis, the available tissue and the information needed by the clinical team.

Research & Innovation in Pathology

Pathology has also played an important role in the research history of Saint John’s Cancer Institute. During the development of sentinel lymph node biopsy for melanoma and breast cancer, Institute investigators and pathologists helped establish methods for examining sentinel lymph nodes that became part of modern cancer staging.

That connection between laboratory science, pathology and clinical care continues through translational research designed to improve how cancers are detected, characterized and monitored.

Understanding Your Pathology Results

A pathology report contains detailed medical information, but patients should not have to interpret it alone. Your treating physician can explain the findings, how they relate to your diagnosis and whether additional testing or treatment should be considered.

Behind every pathology report is a diagnostic process designed to give the clinical team the clearest information possible for coordinated decision-making and individualized care.