Improving diagnostic standards: a two-cycle clinical audit on core biopsy reports adherence to international guidelines for breast lesions.

BACKGROUND

Breast cancer accounts for 24.5% of all cancer cases in women globally, with over 670 000 deaths annually. Early detection and accurate diagnosis are crucial, with breast biopsy reports being key to diagnosis and prognosis. This audit assessed the quality of breast biopsy reports to improve adherence to standardized reporting.

METHODS

A two-cycle clinical audit was conducted at Fauji Foundation Hospital. The first cycle (January 1-March 1, 2024) reviewed 200 biopsy reports against the Royal College of Pathologists' minimum dataset. Identified deficiencies led to an educational intervention, including targeted training and a standardized reporting template. The second cycle (May 16-July 10, 2024) evaluated the intervention's impact.

RESULTS

The first cycle showed high compliance in documenting patient profiles and certain pathological findings, but revealed notable gaps in reporting hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR]) and Human Epidermal growth factor Receptor 2 (HER2) metrics (67.1% compliance). Following the educational intervention and implementation of a standardized template, compliance for these metrics improved to 80.2%. Additional improvements were observed in the use of B category classification, histological typing, and overall adherence to the Royal College of Pathologists' minimum dataset.

CONCLUSION

The intervention significantly improved the quality of breast biopsy reports, particularly in the documentation of hormone receptor status and HER2 metrics. Sustained training, periodic audits, and continued use of standardized templates are recommended to maintain and further enhance reporting standards.