Pathological prognostic factors in breast carcinoma

OBJECTIVE: Pathological prognostic factors in breast cancer are now widely used to predict biological behavior of cancer and to plan its effective management. In this paper, we attempt to evaluate the reports from our histopathology laboratory spanning over a period of 4 years, to assess completeness in recording these factors. It will enable us to improve and standardize reporting on breast cancer.

METHODS: The pathology reports of primary carcinoma of the breast diagnosed in our laboratory from 1st January 1994 to 31st December 1997 (4 year period) were reviewed for details on tumor size, histological type and grade, presence or absence of tumor emboli in vascular channels, proximity of the tumor to resection margins and lymph node status.

RESULTS: Tumor size was not recorded in 1 case each in 1994, 1995 and 1996 and 2 cases in 1997. Histological type was mentioned in all cases in 1995 and 1997. It was not mentioned in 1 case in 1994 and 3 cases in 1996. Out of 77 cases with axillary clearance, the total number of lymph nodes was recorded in 83% of cases. The number of lymph nodes with metastasis was recorded in 71% of cases.

CONCLUSION: Our histopathology laboratory receives the majority of surgical biopsies carried out in the Sultanate of Oman. During our study period we received a total of 45354 biopsies. From 1993 onwards, pathological prognostic factors of breast carcinoma were incorporated in our pathology reports following the publication of major and leading articles regarding the same. This study shows an improvement in the quality of reports after introducing this concept in 1994. This study clearly reveals the necessity for written protocols to be established, to standardize and improve the quality of reporting.