Impact of prostate biopsy secondary pathology review on radiotherapy management

The Prostate ◽  
2021 ◽  
Author(s):  
Michael Siedow ◽  
Mariah Eisner ◽  
Alexander Yaney ◽  
Iman Washington ◽  
Debra Zynger ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Secondary Pathology ◽  
Pathology Review

The value of secondary pathology review.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 7-7 ◽  
Author(s):  
Lavinia P Middleton ◽  
Tinisha L. Mayo ◽  
Tracy E. Spinks ◽  
Richard Cheney ◽  
Peiguo Chu ◽  
...  
Keyword(s):  
Cancer Care ◽  
Diagnostic Errors ◽  
Near Misses ◽  
Appropriate Treatment ◽  
Level Data ◽  
Secondary Pathology ◽  
Major Discrepancy ◽  
Discrepancy Rate ◽  
Discrepant Case ◽  
Pathology Review

6 Background: Improving the value of cancer care is a major focus for the Alliance of Dedicated Cancer Centers (ADCC). Looking to align with the Institute of Medicine’s (IOM) initiative to “Develop and deploy approaches to identify, learn from, and reduce diagnostic errors and near misses in clinical practice,” the ADCC implemented a study to examine the clinical impact of expert secondary pathology review. The goal of this project was to: 1) demonstrate the value of secondary review of outside pathological specimens by ADCC subspecialty pathologists in identifying significant errors that can potentially impact treatment; and 2) create an opportunity to improve patient cancer care. Methods: All consult slides from patients referred to each ADCC center were reviewed by designated pathologists. Patient-level data for original and revised diagnoses were collected for two months in 2014. Discrepancies were classified as: 1) major - diagnosis changes treatment or surveillance; or, 2) minor - diagnosis does not change affect treatment or surveillance. To verify these assessments, disease-specific, multi-center teams of clinical experts reviewed each discrepant case and provided treatment recommendations for the original and revised diagnoses. Results: A total of 13,109 cases were collected across all ADCC centers and the discrepancy rate was 11% (1,488/1309); 3% (359/13,109) were major and 9% (1,129/13,109) were minor. The most common discrepancy was reclassification of the neoplasm cell type. The highest discrepancy rate was shown in the neuro-oncology and head and neck cases, with a 7% and 4% major discrepancy rate respectively. Conclusions: We identified an overall discrepancy rate of 11%, with 3% of cases leading to a change in treatment or surveillance. This demonstrates the importance of expert pathology review and that secondary pathology review can significantly improve clinical outcomes through precise and accurate pathological diagnoses. As indicated in the recent IOM report, this project further demonstrates that “diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions.”

MP75-12 THE SECOND OPINION PATHOLOGY REVIEW IMPROVES CONCORDANCE BETWEEN PROSTATE BIOPSY AND RADICAL PROSTATECTOMY SPECIMENS

2020 ◽  
Vol 203 ◽  
pp. e1146
Author(s):  
Yuki Maruyama* ◽  
Takuya Sadahira ◽  
Motoo Araki ◽  
Yosuke Mitsui ◽  
Koichiro Wada ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
Second Opinion ◽  
Pathology Review

Second Opinion Expert Pathology Review in Bladder Cancer: Implications for Patient Care

2017 ◽  
Vol 26 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Jennifer Gordetsky ◽  
Robin Collingwood ◽  
Win Shun Lai ◽  
Maria Del Carmen Rodriquez Pena ◽  
Soroush Rais-Bahrami
Keyword(s):  
Patient Care ◽  
Demographic Data ◽  
Tumor Resection ◽  
Primary Diagnosis ◽  
Second Opinion ◽  
Tumor Type ◽  
Patient Demographic ◽  
Secondary Pathology ◽  
And Gender ◽  
Pathology Review

Objectives. To review bladder specimens referred to our facility for secondary review to determine the frequency and degree of changes in pathological diagnoses, which could affect patient care. Methods. A retrospective review of 246 bladder specimens sent to our pathology department for second opinion pathological review was performed. All consultation specimens were reviewed by a single genitourinary (GU)-subspecialized surgical pathologist. Any changes in the pathological grade, stage, or histological tumor type were noted as well as patient demographic data. Statistical analysis was performed to determine the frequency and type of discrepancies in diagnoses and determine any associations with patient demographic parameters. Results. Secondary pathology consultation of 246 bladder specimens from 233 patients were reviewed and compared with the primary diagnosis. The diagnosis was altered in 91/246 cases (37.0%). The number of cases reviewed per patient and specimen type was not associated with a change in diagnosis ( P = .19; P = .1). Of the cases with a change in diagnosis, 8 (8.8%) changed malignancy status, 46 (50.5%) changed stage, 16 (17.6%) changed tumor type (ie, change from urothelial carcinoma to prostate adenocarcinoma), 16 (17.6%) changed histological variant subtype, and 14 (15.4%) changed grade. There was no association noted between age, gender, or race and changes in diagnosis ( P = .53; P = .41; P = .70). Conclusions. Secondary pathology review with a GU-subspecialized surgical pathologist can change the stage, grade, or histological subtype on bladder biopsy and tumor resection specimens in more than one-third of cases. Age and gender were not associated with the frequency of change in diagnosis on consultation review.

426 CLINICAL UTILITY OF SECOND OPINION PATHOLOGY REVIEW OF PROSTATE BIOPSY SPECIMENS

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Drew Freilich ◽  
David Maerz ◽  
Huayun Islam ◽  
John Phillips
Keyword(s):  
Prostate Biopsy ◽  
Clinical Utility ◽  
Second Opinion ◽  
Biopsy Specimens ◽  
Pathology Review

Impact of Routine Pathology Review on Treatment for Node-Negative Breast Cancer

2012 ◽  
Vol 30 (18) ◽  
pp. 2227-2231 ◽  
Author(s):  
Hagen F. Kennecke ◽  
Caroline H. Speers ◽  
Catherine A. Ennis ◽  
Karen Gelmon ◽  
Ivo A. Olivotto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Tumor Biology ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Secondary Pathology ◽  
Cancer Agency ◽  
The Impact ◽  
Pathology Review

Purpose Routine secondary pathology review influences diagnosis and treatment among patients diagnosed with breast cancer. The impact of review on patients with node-negative breast cancer and the nature of the pathology elements leading to management changes are not well described. Methods Patients with node-negative, invasive, or in situ breast cancer and evaluable nodes referred to the British Columbia Cancer Agency during two time periods between 2004 and 2007 were included. Pathologists with expertise in breast cancer reviewed the original reports and slides. Biomarker testing was not routinely repeated. Medical record review was conducted to determine whether original pathology was changed and whether recommended therapy was affected. Results Among 906 eligible patients, 405 (45%) received a pathology review. Univariate comparisons revealed that reviewed patients were younger (P < .001) and more likely to have close margins (P < .001), whereas other characteristics were similar. A total of 102 pathology changes were documented among 81 patients (20%). The most frequently changed elements were grade (40%) and lymphovascular (26%), nodal (15%), and margin (12%) status. These changes resulted in 27 treatment modifications among 25 patients (6%). Treatment changes were primarily related to nodal and margin status, and only two of 27 were related to measurement of tumor biology in women with estrogen receptor–positive, node-negative breast cancer. Conclusion Reported rates of change are significant and warrant routine secondary pathology review among patients with node-negative breast cancer or ductal carcinoma in situ before final treatment is recommended. Review remains relevant in the era of gene expression signatures to determine margin and nodal status.

Change in Prostate Biopsy Pathology Reading on a Second Pathology Review at an Academic Medical Center

2014 ◽  
Vol 90 (1) ◽  
pp. S426
Author(s):  
S.M. Miller ◽  
B.R. Baker ◽  
D. Canasi ◽  
V. Somasundaram ◽  
R. Handa ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Pathology Review

scholarly journals The second opinion pathology review improves concordance between prostate biopsy and radical prostatectomy specimens

2020 ◽  
Vol 19 ◽  
pp. e1556-e1557
Author(s):  
Y. Maruyama ◽  
T. Sadahira ◽  
M. Araki ◽  
Y. Mitsui ◽  
K. Wada ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
Second Opinion ◽  
Pathology Review

396: Does a Prostate Biopsy Scheme with a Saturation Technique Improve the Cancer grade, stage and Margin status more Accurately at the Time of Radical Prostatectomy ?

2007 ◽  
Vol 177 (4S) ◽  
pp. 132-132
Author(s):  
Stephane Mallick ◽  
Yann Fouques ◽  
Sophie Le Toquin ◽  
Antoine Dufour ◽  
Henri Bensadoun
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
Margin Status

530: Termining Risk for Prostate Cancer at Prostate Biopsy using Genetic Markers

2005 ◽  
Vol 173 (4S) ◽  
pp. 144-145
Author(s):  
Robert K. Nam ◽  
William Zhang ◽  
John Trachtenberg ◽  
Michael A.S. Jewett ◽  
Steven Narod
Keyword(s):  
Prostate Cancer ◽  
Genetic Markers ◽  
Prostate Biopsy
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