The Pathology of Breast Cancer

When reporting on a breast carcinoma specimen, it is required that reporting be done giving information about several different aspects (1) . It is easy to be overwhelmed with the histopathology data. The mnemonic “STINGER.COM” is meant as an aide memoire regarding the key things to be reported on.


Size in mm of index invasive tumour


Type / Total size

Type i.e. Ductal, Lobular etc

Total size of tumour i.e. Invasive + DCIS


Invasion (Lymphovascular) i.e Absent/Present


Nodes (involvement) e.g 0/2, 2/5 etc


Grade i.e. 1,2 or 3


Extent i.e. Localised, Multifocal, Multicentric etc



ER e.g 0/8,8/8 etc

PR e.g 0/8,8/8 etc

HER 2 status

FISH status




Carcinoma in situ


Size in mm

Type i.e. DCIS,LCIS etc


Other pathology


Type i.e. Paget’s, Atypical Ductal Hyperplasia etc



Margins i.e. distance of disease from closest relevant margin

Microinvasion Absent/Present




(1) Ellis I, Al-Sam S, Anderson N, Carder P, Deb R, Girling A, et al. Pathology reporting of breast disease in surgical excision specimens incorporating the dataset for histological reporting of breast cancer June 2016. 2016.