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Tumor Site

Tumor Size (cm)

Histologic Type and Grade

Histologic grade dermination
Mitotic Rate
Mitotic rate should be reported as number of mitoses per 2 mm2, by evaluating at least 10 mm2 in the most mitotically active part of the tumor (eg, if using a microscope with a field diameter of 0.55 mm, count 42 high-power fields [10 mm2] and divide the resulting number of mitoses by 5 to determine the number of mitoses per 2 mm2 needed to assign tumor grade)

Ki-67 Labeling Index

Tumor Extent

Lymphovascular Invasion

+ Perineural Invasion

Choose margins examined

Distant Metastasis

Pathologic Staging (pTNM)
TNM Descriptors (select all that apply)

+ Additional Pathologic Findings