Breast cancer: do histopathology reports provide adequate information for patient care?

ABSTRACT

INTRODUCTION: Many studies have shown that certain pathologic features correlate with risk of recurrence, development of nodal and distant metastases, long term survival and multicentricity of breast carcinoma. Such information is useful in selection of appropriate therapy and prognostication. OBJECTIVE: To determine the proportion of histopathology reports of breast carcinoma that provide essential pathologic prognostic information. METHOD: All (110 mastectomy and 25 lumpectomy) cases of breast carcinoma reported during 79-month period from January 1992 were assessed for inclusion of tumour size, information on excision margins and 8 microscopic features. Mastectomy reports were evaluated for information on axillary lymph node status. RESULTS: 9.6% of reports assessed included all relevant features. All 110 mastectomy reports gave information on axillary lymph node status. Tumour size was included in 91.1% of reports. Excision margins were commented on in 36% of lumpectomy reports. Of the microscopic features assessed, tumour type was included in 98.5% and histologic grade in 66.7%. In formation on other features ranged from 28.1% for inflammatory infiltrate at the tumour-host interface to 69.1% for nipple invasion. CONCLUSION: Reporting on basic prognostic information falls short of the ideal. Provision of guidelines will help to ensure the inclusion of relevant histopathologic prognostic information.