Errors in breast cancer pathology reports

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Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. This is not true. Pathology reports are subjective.

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Pathology must aim at a correct and complete diagnosis for the patient, which is timely, useful, and understandable to the physician assistant. However, in daily practice, there are multiple possibilities of errors in the pathology laboratory, with several impacts on patient care and prognosis. In this chapter, we discuss the different concepts of error and diagnostic concordances in pathology, at which point in the diagnostic process the errors are more frequent, and propose solutions to minimize the chance of their occurrence.

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June — With core needle biopsies of the breast, if something looks like an epithelial malignancy, ask yourself: Is it really a carcinoma? If it is a carcinoma, ask yourself if it is a primary breast carcinoma. Collins, vice chair of anatomic pathology and director of breast pathology, Beth Israel Deaconess Medical Center, and professor of pathology, Harvard Medical School, shared pointers on how to stay out of trouble on core needle biopsies of the breast.

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It is a good idea to seek a second opinion on your pathology report if a change could affect the nature of your treatment. These errors included mistakes in staging, misidentification of the type of cancer, and misdiagnosis of a benign tumor as malignant and vice versa. A study at Northwestern University of breast cancer patients found that errors in breast cancer pathology reports would affect the decision to choose between a lumpectomy and mastectomy 7. Another Northwestern University study of breast cancer patients found that second opinions resulted in changes in the management of 54 patients

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The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near-miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistencies between the histologic findings and patient age, unveiling specimen identification errors.

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File photograph: Getty Images. Inhaving discovered a lump in her right breast she was diagnosed with DCIS Ductal carcinoma in situ a localised form of breast cancer which, she was told, could be completely dealt with through surgery. The procedure was carried out but two years later Ms McCormack discovered a lump in her neck.

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There are two kinds of second opinions that can help you. You should get both kinds of second opinions. Get a pathology second opinion before getting a treatment second opinion.

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It was the sort of bad news every patient fears. Merlin Erickson, a year-old retired engineer in Abingdon, Md. Erickson, worried, began investigating the options: whether to have his prostate removed, or perhaps to have radiation treatment. But a few days later, the doctor called again.


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