What You Should Know about Recent Studies on Pathology Diagnoses

March 25, 2015 Kathi Adamson, MD

If recent media coverage questioning the accuracy of pathology diagnoses on breast biopsies has you worried, you’re not alone. 

A recent study published by Elmore et al investigated diagnostic agreement for breast biopsies between individual pathologists and “consensus-derived reference diagnoses” rendered by a panel of three pathologists.  While variable rates of diagnostic disagreement were identified, it is important to realize that the strict study design and methodology are not applicable to the daily practice of pathology. 

In real life practice, pathologists are not restricted by the number of slides available for review, and typically evaluate multiple slides/tissue levels for each breast biopsy sample.  In addition, practicing pathologists are able to obtain a consultative opinion from another pathologist in order to make a diagnosis—something that was not permitted in the study by Elmore et al.  Consultative opinions are a key component of pathology practice, and are especially important in the evaluation of breast biopsies.  Therefore, while the study findings are certainly alarming, they do not accurately reflect the routine practice of pathology.

As a patient, you should feel confident in the pathologists and diagnoses you receive. Physicians from Swedish and CellNetix work together to ensure the patient’s tissue is handled properly following the biopsy and pathologists are able to obtain a consultative opinion from a fellow pathologist easily. This happens often – at CellNetix, for example, approximately 40% of all breast specimens are reviewed by at least two separate pathologists. In fact, all biopsies that might prompt surgical excision receive an intradepartmental consultation from another pathologist, including a number of pathologists with specialty expertise in breast pathology.  We encourage patients to review a copy of their pathology report and look for the “intradepartmental consult” section. And if you have questions about your pathology report, you can always speak with your doctor, or call the phone number on your pathology report to speak with the pathologist who reviewed your report.

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