Quality control in histopathological diagnosis of breast carcinoma

Within the framework of the Hessian quality control program for histopathol ogical diagnosis of breast cancer, views are expressed on th ree questions that pertain to the responsibilities and goals of pathology. Histopathologi cal diagnostic is not a static method, but rather one with a morphological basis oriented towards progress. Classifications are subject to changes and additions that occasionally influence practical diagnostics. Therefore, th e applied or conventional histopathological diagnostics should always be ch ecked to ensure they meet current standards. Histopathological consultations to investigate problematic cases of breast cancer (Fulda register) have been held since 1976 to scrutinize 6700 cases. Of these, 620 cases dating from the years 1998 and 1999 were analyzed with regard to the diagnostic quality of the contributing pathologists. In 6.6% of the cases, the diagnosis was incorrect, which could have had therapeuti c and prognostic consequences for 3.6% of the cases. The result of this stu dy justifies awarding a high standard of quality to histopathological diagn ostics. The high quality demands imposed on histopathological diagnostics can only be fulfilled by considerable improvement of collaboration between gynecolog ists, radiologists, and pathologists, in addition to specialized knowledge. The diagnostic and therapeutic measures should be discussed among all part icipants at pre- and postoperative interdisciplinary consultations.