van Dooijeweert C, Baas I O, Deckers I A G, van der Wall E, van Diest P J
UMC Utrecht, afd. Pathologie, Utrecht.
Contact: C. van Dooijeweert (
Ned Tijdschr Geneeskd. 2021 Jan 14;164:D5441.
The pathologist's assessment of tumor tissue plays a critical role in therapeutic decision-making in early-stage invasive breast cancer. In daily practice, however, there appears to be considerable variation in grading between the different Dutch pathology laboratories and between individual pathologists within the same laboratory. This underlines the need to standardize grading by pathologists as much as possible in order to minimize the risk of a worse outcome for patients due to under-treatment and of unnecessary toxicity from over-treatment. Therefore, two initiatives were launched, i.e. laboratory-specific feedback reports and an e-learning module in which pathologists were trained in grading of invasive breast cancer. While these initiatives have yielded encouraging results, the overall variation in grading remains significant. Awareness of this variation, and of the inherent difficulties of subjective grading, among the various clinicians involved in breast cancer management, is therefore of utmost importance to improve clinical decision-making for patients.
病理学家对肿瘤组织的评估在早期浸润性乳腺癌的治疗决策中起着关键作用。然而，在日常实践中，荷兰不同病理实验室之间以及同一实验室的个体病理学家之间的分级似乎存在相当大的差异。这凸显了尽可能使病理学家的分级标准化的必要性，以将因治疗不足导致患者预后较差以及过度治疗带来不必要毒性的风险降至最低。因此，发起了两项举措，即实验室特定的反馈报告和一个电子学习模块，在该模块中对病理学家进行浸润性乳腺癌分级方面的培训。虽然这些举措取得了令人鼓舞的结果，但分级的总体差异仍然很大。因此，参与乳腺癌管理的各类临床医生了解这种差异以及主观分级所固有的困难，对于改善患者的临床决策至关重要。
