Quality of Breast Cancer Surgical Pathology Reports

Background: Surgical pathology reporting of breast cancer is needed for appropriate staging and treatment decisions. We here checked the quality of surgical pathology reports of breast cancer from different laboratories of Karachi, Pakistan. Methods: One hundred surgical pathology reports from ten different laboratories of Karachi were assessed for documentation of elements against a checklist adopted from the CAP guideline over a period of six months from January, 2017 to June, 2017 in the Oncology Department, Jinnah Postgraduate Medical Centre, Karachi. Results: Out of 100 reports, clinical information was documented in 68%, type of procedure and lymph node sampling in 84% and 34% respectively. Specimen laterality was mentioned in 90%, tumor site in 44%, tumor size in 92%, focality in 40%, histological type in 96%, grade in 87%, LCIS in 19%, DCIS in 83%, size of DCIS in 19%, architectural pattern in 26% , nuclear grade in 17%, necrosis in 14%, excision margin status in 91%, invasive component in 83%, DCIS in 16%, lymph node status in 91% with positive nodes in 56%, size of macro met in 54%, extranodal involvement in 48%, lymph vascular invasion in 86%, treatment effects in 31%, and pathology reporting with TNM in 57%. Conclusion: This study shows that the quality of surgical pathology reports for breast cancer in Karachi is not satisfactory. Therefore, there is great need to create awareness among histopathologists regarding the importance of accurate breast cancer surgical pathology reporting and to introduce a standardized checklist according to international guidelines for better treatment planning.