乳腺癌手术后病理报告切缘状态质量的变异性。

Variability in the quality of pathology reporting of margin status following breast cancer surgery.

机构信息

The University of Vermont College of Medicine, Burlington, VT, USA.

出版信息

Ann Surg Oncol. 2011 Oct;18(11):3061-5. doi: 10.1245/s10434-011-1916-8. Epub 2011 Sep 27.

DOI:10.1245/s10434-011-1916-8

PMID:21947586

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3661000/

Abstract

BACKGROUND

Accurately determining margin status is important for breast cancer treatment. The College of American Pathologists (CAP) developed guidelines to standardize reporting of margin status. The aim of this study is to determine statewide concordance with CAP breast cancer reporting guidelines for margin status.

METHODS

The Vermont Breast Cancer Surveillance System (VBCSS) tracks mammography-related services provided to all women treated for breast cancer at hospitals in Vermont. These data include accompanying pathology reports, which were analyzed for descriptions of margin status. The CAP protocols have both requirements and recommendations for margin status reporting. Reports were "minimally compliant" if they adhered to the requirements stated in the CAP protocols or "maximally compliant" if they included the recommended protocols in addition to those required.

RESULTS

There were 2,016 reports that met the inclusion criteria. A total of 71.1% were minimally compliant and 37.3% were maximally compliant with the CAP guideline standards. There was a statistically significant rise in compliant reports, with minimally compliant reports increasing from 55.7% in 1998 to 79.3% in 2006, and maximally compliant reports rising from 4.7% in 1998 to 53.7% in 2006 (χ(2) trend test, P < 0.001) for both cohorts.

CONCLUSIONS

Reporting of margin status in breast-conserving surgery varies widely. There is a significant rise in guideline compliance with margin status reporting from 1998 to 2006; however, overall compliance remains suboptimal. This study provides evidence to support the need for quality improvement measures in the implementation of CAP guidelines for reporting margin status following breast-conserving surgery.

摘要

背景

准确确定切缘状态对乳腺癌的治疗非常重要。美国病理学家学院（CAP）制定了指南，以规范切缘状态的报告。本研究的目的是确定全州范围内与 CAP 乳腺癌报告指南在切缘状态方面的一致性。

方法

佛蒙特州乳腺癌监测系统（VBCSS）跟踪所有在佛蒙特州医院接受乳腺癌治疗的女性的乳房 X 光检查相关服务。这些数据包括伴随的病理报告，对这些报告进行了切缘状态的分析。CAP 方案既有切缘状态报告的要求，也有建议。如果报告符合 CAP 方案中的要求，则为“最低限度符合”；如果报告包括 CAP 方案中规定的推荐方案，则为“最大限度符合”。

结果

共有 2016 份报告符合纳入标准。其中 71.1%为最低限度符合，37.3%为最大限度符合 CAP 指南标准。符合 CAP 指南标准的报告数量呈上升趋势，1998 年最低限度符合报告比例为 55.7%，2006 年上升至 79.3%，1998 年最大限度符合报告比例为 4.7%，2006 年上升至 53.7%（χ²趋势检验，P<0.001），两个队列均如此。