ADEQUACY OF HISTOPATHOLOGY REPORTS FOR BREAST-CANCER IN NEW-SOUTH-WALES

To assess the adequacy of diagnostic histopathology reports for breast cancer in New South Wales (NSW) and the Australian Capital Territory (ACT), a cross-sectional survey of diagnostic histopathology reports w as carried out on a random sample (n = 1000) of NSW and ACT women diag nosed with breast cancer in 1992 and notified to the NSW Central Cance r Registry. A single pathologist with expertise in breast cancer revie wed the reports, from laboratories in public and private sectors, agai nst a checklist enumerating basic features considered useful for decis ion making by surgeons and/or medical and radiation oncologists. While information was provided by almost all reports bn histological classi fication (94%), size of tumor (93%) and involvement of lymph nodes (99 .8%), this was not so for tumor resection/biopsy margin (77%), histolo gical grade (69%), nuclear grade (23%), mitotic rate (11%) and the pre sence or absence of lymphatic (34%) or vascular (24%) invasion. Pathol ogists from teaching hospitals and those who reported on more than 10 cases in the sample were more likely to provide relevant information. Many diagnostic histopathology reports for breast cancer did not fulfi l the requirements for a satisfactory report, established prognostic a nd predictive features frequently being omitted. The uniform use by pa thologists of a carefully designed checklist could ensure that standar d information is provided for every breast cancer, thereby facilitatin g choice of therapy for all patients.