BACKGROUND: Examination of pathology slides is a routine part of a breast cancer second opinion. The purpose of this study was to determine how often the pathologic second opinion (1) altered the diagnosis and (2) resulted in a change in the surgical procedure. METHODS: Patients presenting between 1997 and 2001 for a second opinion after a biopsy diagnosis of breast cancer (invasive or noninvasive) were included in this study. RESULTS: There were 340 patients presenting for second opinions regarding 346 breast cancers. Sixty-eight pathologic second opinions (20%) did not result in any change in pathology or prognostic factors, whereas in the remaining 80%, some change occurred. Major changes that altered surgical therapy occurred in 7.8% of cases, and pathology review provided additional prognostic information in 40%. Changes were more common in in situ carcinoma than invasive carcinoma (P =.004), but biopsy type (core vs. excisional biopsy) was not a significant predictor of change in pathologic information. CONCLUSIONS: This study confirms the benefit of a pathology second opinion to improve preoperative estimates of prognosis and to determine the appropriate surgical procedure. Missing information on grade and histological subtype was responsible for a large number of cases, suggesting a need for widespread application of standardization and quality improvement in pathology reporting.
BACKGROUND: Examination of pathology slides is a routine part of a breast cancer second opinion. The purpose of this study was to determine how often the pathologic second opinion (1) altered the diagnosis and (2) resulted in a change in the surgical procedure. METHODS:Patients presenting between 1997 and 2001 for a second opinion after a biopsy diagnosis of breast cancer (invasive or noninvasive) were included in this study. RESULTS: There were 340 patients presenting for second opinions regarding 346 breast cancers. Sixty-eight pathologic second opinions (20%) did not result in any change in pathology or prognostic factors, whereas in the remaining 80%, some change occurred. Major changes that altered surgical therapy occurred in 7.8% of cases, and pathology review provided additional prognostic information in 40%. Changes were more common in in situ carcinoma than invasive carcinoma (P =.004), but biopsy type (core vs. excisional biopsy) was not a significant predictor of change in pathologic information. CONCLUSIONS: This study confirms the benefit of a pathology second opinion to improve preoperative estimates of prognosis and to determine the appropriate surgical procedure. Missing information on grade and histological subtype was responsible for a large number of cases, suggesting a need for widespread application of standardization and quality improvement in pathology reporting.
Authors: Brian Shuch; Jonathan N Hofmann; Maria J Merino; Jeffrey W Nix; Srinivas Vourganti; W Marston Linehan; Kendra Schwartz; Julie J Ruterbusch; Joanne S Colt; Mark P Purdue; Wong-Ho Chow Journal: Urol Oncol Date: 2013-02-28 Impact factor: 3.498
Authors: Habib Rahbar; Elizabeth S McDonald; Janie M Lee; Savannah C Partridge; Christoph I Lee Journal: Acad Radiol Date: 2016-03-23 Impact factor: 3.173
Authors: Eileen Rakovitch; Sharon Nofech-Mozes; Wedad Hanna; Rinku Sutradhar; Frederick L Baehner; Dave P Miller; Cindy Fong; Sumei Gu; Alan Tuck; Sandip Sengupta; Leela Elavathil; Prashant A Jani; Michel Bonin; Martin C Chang; Elzbieta Slodkowska; Joseph M Anderson; Diana B Cherbavaz; Steven Shak; Lawrence Paszat Journal: J Natl Cancer Inst Date: 2017-04-01 Impact factor: 13.506
Authors: Melissa Anne Mallory; Katya Losk; Nancy U Lin; Yasuaki Sagara; Robyn L Birdwell; Linda Cutone; Kristen Camuso; Craig Bunnell; Fatih Aydogan; Mehra Golshan Journal: Ann Surg Oncol Date: 2015-07-23 Impact factor: 5.344
Authors: Berta M Geller; Heidi D Nelson; Patricia A Carney; Donald L Weaver; Tracy Onega; Kimberly H Allison; Paul D Frederick; Anna N A Tosteson; Joann G Elmore Journal: J Clin Pathol Date: 2014-07-22 Impact factor: 3.411
Authors: Mehra Golshan; Katya Losk; Melissa A Mallory; Kristen Camuso; Susan Troyan; Nancy U Lin; Sarah Kadish; Craig A Bunnell Journal: Ann Surg Oncol Date: 2015-08-26 Impact factor: 5.344