Error Reduction and Diagnostic Concordance in Breast Pathology

Timothy Isaac Miller; Meghan R Flanagan; Kathryn P Lowry; Mark R Kilgore

doi:10.1016/j.path.2021.11.001

Error Reduction and Diagnostic Concordance in Breast Pathology

Surg Pathol Clin. 2022 Mar;15(1):1-13. doi: 10.1016/j.path.2021.11.001. Epub 2022 Jan 31.

Authors

Timothy Isaac Miller¹, Meghan R Flanagan², Kathryn P Lowry³, Mark R Kilgore⁴

Affiliations

¹ Department of Laboratory Medicine and Pathology, University of Washington, University of Washington Medical Center, 1959 Northeast Pacific Street, Box 357100, Seattle, WA 98195, USA. Electronic address: [email protected].
² Department of Surgery, University of Washington, 1100 Fairview Avenue, M4-B874, Seattle, WA 98109, USA.
³ Department of Radiology, University of Washington, Seattle Cancer Care Alliance, 1144 Eastlake Avenue East, LG-215, Seattle, WA 98109, USA.
⁴ Department of Laboratory Medicine and Pathology, University of Washington, University of Washington Medical Center, 1959 Northeast Pacific Street, Box 357100, Seattle, WA 98195, USA.

PMID: 35236626
DOI: 10.1016/j.path.2021.11.001

Abstract

Errors in anatomic pathology can result in patients receiving inappropriate treatment and poor patient outcomes. Policies and procedures are necessary to decrease error and improve diagnostic concordance. Breast pathology may be more prone to diagnostic errors than other surgical pathology subspecialties due to inherit borderline diagnostic categories such as atypical ductal hyperplasia and low-grade ductal carcinoma in situ. Mandatory secondary review of internal and outside referral cases before treatment is effective in reducing diagnostic errors and improving concordance. Assessment of error through amendment/addendum tracking, implementing an incident reporting system, and multidisciplinary tumor boards can establish procedures to prevent future error.

Keywords: Accuracy; Anatomic; Breast; Concordance; Error; Pathology; Review.

Publication types

Review

MeSH terms

Breast / pathology
Breast Neoplasms* / diagnosis
Breast Neoplasms* / pathology
Carcinoma, Ductal, Breast* / pathology
Carcinoma, Intraductal, Noninfiltrating* / diagnosis
Carcinoma, Intraductal, Noninfiltrating* / pathology
Female
Humans
Pathology, Surgical*