Quality of Histopathological Reporting in Breast Cancer: Results From Four South African Breast Units

High-quality histopathology reporting forms the basis for treatment decisions. The quality indicator for pathology reports from the European Society of Breast Cancer Specialists was applied to a cohort from four South African breast units. The study included 1,850 patients with invasive breast cance...

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Bibliographic Details
Published in:	JCO global oncology Vol. 7; no. 7; pp. 72 - 80
Main Authors:	Toma, Armand, O'Neil, Daniel, Joffe, Maureen, Ayeni, Oluwatosin, Nel, Carolina, van den Berg, Eunice, Nayler, Simon, Cubasch, Herbert, Phakathi, Boitumelo, Buccimazza, Ines, Čačala, Sharon, Ruff, Paul, Norris, Shane, Nietz, Sarah
Format:	Journal Article
Language:	English
Published:	United States American Society of Clinical Oncology 01-12-2021
Subjects:	Biopsy, Large-Core Needle Breast Breast Neoplasms Female Humans ORIGINAL REPORTS Receptor, ErbB-2 Receptors, Estrogen Receptors, Progesterone Research Report
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Summary:	High-quality histopathology reporting forms the basis for treatment decisions. The quality indicator for pathology reports from the European Society of Breast Cancer Specialists was applied to a cohort from four South African breast units. The study included 1,850 patients with invasive breast cancer and evaluated 1,850 core biopsies and 1,158 surgical specimen reports with cross-center comparisons. A core biopsy report required histologic type; tumor grade; and estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) status, with a confirmatory test for equivocal HER2 results. Ki-67 was regarded as optional. Pathologic stage, tumor size, lymphovascular invasion, and distance to nearest invasive margin were mandatory for surgical specimens. Specimen turnaround time (TAT) was added as a locally relevant indicator. Seventy-five percent of core biopsy and 74.3% of surgical specimen reports were complete but showed large variability across study sites. The most common reason for an incomplete core biopsy report was missing tumor grade (17.9%). Half of the equivocal HER2 results lacked confirmatory testing (50.6%). Ki-67 was reported in 89.3%. For surgical specimens, the closest surgical margin was reported in 78.1% and lymphovascular invasion in 84.8% of patients. Mean TAT was 11.9 days (standard deviation [SD], 10.8 days) for core biopsies and 16.1 days (SD, 11.3) for surgical specimens. Histopathology reporting is at a high level but can be improved, especially for tumor grade, HER2, and Ki-67, as is reporting of margins and lymphovascular invasion. A South African pathology consensus will reduce variability among laboratories. Routine use of standardized data sheets with synoptic reports and ongoing audits will improve completeness of reports over time.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2687-8941 2687-8941
DOI:	10.1200/GO.20.00402