Reading your pathology report
Type, receptors, grade, stage, and margins explained, and a tool that turns the words on your own report into plain language and builds a list of questions to bring. Nothing you enter is saved.
Decode your report →Home › Diagnosis and treatment
Diagnosis & treatment
What your diagnosis means, and what happens next
Breast cancer is not one disease. Two people can hear the same three words and end up with completely different treatment, because what matters is the particular kind of cancer, how far it has gone, and what it responds to. Start with your report, then read the page that matches it.
Start with your report, then read about your diagnosis
DCIS, stage 0
Cancer cells that are still inside the milk duct. What it is, what usually happens next and in what order, and the choices you will be asked about.
Read about DCIS →Hormone receptor positive, HER2 negative
The most common type. Surgery usually first, a test on the tumor to decide about chemotherapy, and a daily pill for years afterward.
Read about hormone receptor positive →HER2 positive
About one cancer in six. Medicines that block HER2, usually given with chemotherapy before surgery so everyone can see the cancer respond.
Read about HER2 positive →Triple negative
Negative for all three receptors. Chemotherapy, usually with immunotherapy, comes first for most, and genetic testing is offered to everyone.
Read about triple negative →Lobular breast cancer
About one cancer in ten. Grows in single-file lines rather than a lump, so it is harder to feel and to see, and an MRI is often added before surgery.
Read about lobular →Stage 3, and treatment before surgery
Larger, or in several nodes, or in the skin, but not spread to distant organs. The order changes: medicine nearly always comes first.
Read about stage 3 →Stage 4, and if cancer returns
What metastatic breast cancer and recurrence mean, who leads the care, and where the fuller answers are.
Read about stage 4 →
Start here if the words are the problem
Ductal, lobular, in situ, sentinel node. Most of these make immediate sense once you know what is actually inside a breast, and none of them do before that. How the breast is built takes about five minutes and makes the rest of this page far easier to follow.
How type, receptors, and stage shape the plan
Almost every treatment plan for early breast cancer is built from three kinds of treatment, used in some combination:
- Local treatment to the breast. Surgery, and often radiation. This deals with the cancer where it is.
- Local treatment to the lymph nodes. Checking them, and sometimes treating them.
- Whole-body treatment. Medicine that travels in the bloodstream to deal with any cells that may have escaped. This can be chemotherapy, endocrine therapy, HER2-targeted therapy, immunotherapy, or a combination.
The single most useful thing to understand
Which operation you have does not decide whether you need medicine afterward. Drug treatment is chosen from the characteristics of the tumor, not from the kind of surgery you had. Choosing a mastectomy does not let you avoid chemotherapy, and choosing a lumpectomy does not commit you to it.
And for people who have a genuine choice between the two operations, survival is the same whether you have a lumpectomy followed by radiation or a mastectomy. That fact is decades old and well established, and it is worth hearing plainly, because a great many people choose the bigger operation believing it must be safer.
Why the order of treatment changes
Some people have surgery first and medicine afterward. Others have medicine first. Both are normal.
- means after surgery. Treatment given to lower the chance of the cancer coming back.
- means before surgery. It can shrink a tumor enough that a smaller operation becomes possible, and it shows the team how this particular cancer responds to a particular medicine, which is information you cannot get any other way.
The three parts of treatment: surgery, radiation, medicines
Surgery
Lumpectomy and mastectomy compared honestly, what happens to the lymph nodes, and margins.
Read about surgery →Radiation and medicines
What radiation is like, and the four families of drug treatment: chemotherapy, endocrine therapy, HER2-targeted therapy, and immunotherapy.
Read about treatment →Reconstruction
Implants and flaps compared, immediate against delayed, and the option of not reconstructing at all.
Read about reconstruction →Where this comes from
Sources, checked 23 August 2026
- Susan G. Komen patient fact sheets: What Is Breast Cancer?, Treatment Overview for Breast Cancer, Breast Cancer Surgery, and Hormone Receptor-Positive Breast Cancer, supplied by Dr. Perkins’ office. komen.org
- Gradishar WJ, Moran MS, Abraham J, et al. Breast Cancer, Version 4.2026. Journal of the National Comprehensive Cancer Network 2026;24(7):e260033. NCCN Guidelines for Breast Cancer
- American Cancer Society, Breast Cancer
- American Society of Breast Surgeons
Written for patients, and simplified on purpose. Your own team knows your own case, and what they tell you takes priority over anything on this page.
Not sure where to start?
Call the office and ask. There is no wrong reason to call, and no question too small. For what needs a call tonight rather than tomorrow, see when to call, and when to call 911.