Quality of Histopathological Reporting in Breast Cancer: Results From Four South African Breast Units. (2021)

• Record Type: Journal Article
• 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
• Is Part Of: JCO global oncology. Volume 7(2021)
• Publication Date: 2021
• Subjects: Oncology -- Periodicals; Medical Oncology; Neoplasms; Oncology; Electronic journals; Periodical; Periodicals; 616.994005
• DOI: 10.1200/GO.20.00402
• Languages: English
• ISSNs: 2687-8941

Abstract

Abstract : PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.