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Outside the Lab Regulation and standards, Oncology, Training and education, Histology, Clinical care, Profession

Collaborating on Cancer Care

Commenting in response to the JAMA article published in March 2015 on diagnostic concordance among pathologists interpreting breast biopsy specimens (1)…

The major challenge in diagnosing the potential for breast cancer at the premalignant stages lies in recognizing it. In many cases, needle biopsy does a good initial job by allowing the pathologist to properly triage the patient and identify a lesion that’s better examined with an excisional biopsy. Practices that don’t do secondary prospective review of problematic cases face an additional obstacle to diagnosis; this is critical for high quality work and I would personally consider it mandatory. A robust quality management program that includes specific criteria for mandatory prospective review of complex cases – things that will result in significant clinical impact – is imperative to render quality, reproducible diagnoses. One final challenge that may exist for some practices is the lack of a “team effort” by collaborating clinicians. It’s imperative for pathologists to have access to other treating clinicians like radiologists, oncologists, and surgeons. No field of medicine can practice in isolation.

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About the Author

Michael Misialek

Michael Misialek is Associate Chair of Pathology at Newton-Wellesley Hospital, Newton and Medical Director of the Vernon Cancer Center, USA.

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