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Cited by 91Breast Lesions and CarcinomasBreast Cancer Treatment StudiesAI in cancer detection

Changes in breast cancer therapy because of pathology second opinions

Staradub, Valerie L., Messenger, Kathleen A., Hao, Nanjiang, Wiely, Elizabeth L., Morrow, Monica·2002·Annals of Surgical Oncology
DOI 10.1007/bf02574516
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Abstract

Background Examination of pathology slides is a routine part of a breast cancer second opinion. The purpose of this study was to determine how often the pathologic second opinion (1) altered the diagnosis and (2) resulted in a change in the surgical procedure.Methods Patients presenting between 1997 and 2001 for a second opinion after a biopsy diagnosis of breast cancer (invasive or noninvasive) were included in this study.Results There were 340 patients presenting for second opinions regarding 346 breast cancers. Sixty-eight pathologic second opinions (20%) did not result in any change in pathology or prognostic factors, whereas in the remaining 80%, some change occurred. Major changes that altered surgical therapy occurred in 7.8% of cases, and pathology review provided additional prognostic information in 40%. Changes were more common in in situ carcinoma than invasive carcinoma (P =.004), but biopsy type (core vs. excisional biopsy) was not a significant predictor of change in pathologic information.Conclusions This study confirms the benefit of a pathology second opinion to improve preoperative estimates of prognosis and to determine the appropriate surgical procedure. Missing information on grade and histological subtype was responsible for a large number of cases, suggesting a need for widespread application of standardization and quality improvement in pathology reporting.

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  • It is estimated that the error rate of cancer histopathology can be as high as 23%.

    “This is important, as it is estimated that the error rate of cancer histopathology can be as high as 23% (20–23).”

    From Radiomics: Images Are More than Pictures, They Are Data (2016) · cites this paper as [22]

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Authors
Staradub, V. L., Messenger, K. A., Hao, N., Wiely, E. L., & Morrow, M.
Affiliations
Northwestern University (US)
Corresponding author
Staradub, Valerie L.
ORCID
Morrow, Monica
Venue
Annals of Surgical Oncology
Publisher
Springer Science and Business Media LLC
Published
2002-12
Volume
9
Issue
10
Pages
982-987
ISSN
  • 1068-9265 (ISSN-L)
  • 1534-4681
DOI
10.1007/bf02574516
OpenAlex
W2072504371
Cited by
91
References
33
Citations by year
2026: 1 · 2025: 1 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 4 · 2017: 7 · 2016: 3 · 2015: 10 · 2014: 5 · 2013: 9 · 2012: 5
FWCI
0.85
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Annals of Surgical Oncology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (P50CA089018, P50 CA89018)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
Keywords
breast cancer, second opinion, pathology review, breast cancer surgery, prognostic factors, breast cancer in situ, invasive breast cancer, histological grade, histological subtypes, core needle biopsy, excisional biopsy
MeSH terms
Biopsy, Breast Neoplasms, Carcinoma, Carcinoma in Situ, Carcinoma, Intraductal, Noninfiltrating, Chicago, Diagnostic Errors, Humans, Neoplasm Staging, Prognosis, Referral and Consultation

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