title: Quality of pathology reporting is crucial for cancer care and registration: a baseline assessment for breast cancers diagnosed in Belgium in 2008.
abstract: OBJECTIVE
  Given the crucial role of pathology reporting in the management of breast cancers, we aimed to investigate the quality and variability of breast cancer pathology reporting in Belgium.
  
  
  METHODS
  Detailed information on non-molecular and molecular parameters was retrieved from the pathology protocols available at the Belgian Cancer Registry for 10,007 breast cancers diagnosed in Belgium in 2008.
  
  
  RESULTS
  Substantial underreporting was shown for several clinically relevant non-molecular parameters, such as lymphovascular invasion. High-volume laboratories performed only slightly better than others, and analyses at the individual laboratory level showed clear inter-laboratory variability in reporting for all volume categories. Information on ER/PR and HER2 IHC was mentioned in respectively 91.7% and 90.8% of evaluative cases. HER2 ISH data were available for 78.5% of the cases judged to be 2+ for HER2 IHC. For cases with different specimens analysed, discordance between these specimens was highest for HER2, followed by PR. For HER2, results obtained from different laboratories were even less concordant. In addition, inter-laboratory differences were noted in the used ER/PR scoring systems, the proportion of ER-/PR+ cases, and the relation between histological grade and ER/PR positivity. Data on Ki67 were only available for 43.8% of the investigated cases, and showed inconsistent use of cut-off values.
  
  
  CONCLUSIONS
  Breast pathology reporting in Belgium in 2008 was suboptimal and showed considerable inter-laboratory variability. Synoptic reporting has been proposed as a facilitator towards increased reporting quality and harmonization, but the lack of aligned informatics remains a major hurdle in its concrete implementation.
authors.affiliation: Belgian Cancer Registry, Koningsstraat 215 box 7, 1210, Brussels, Belgium. Electronic address: harlinde.deschutter@kankerregister.org.
authors.forename: H
authors.initials: H
authors.lastname: De Schutter
authors.affiliation: Belgian Cancer Registry, Koningsstraat 215 box 7, 1210, Brussels, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Van Damme
authors.affiliation: Department of Pathology, GZA Hospitals and Antwerp University Hospital, Wilrijkstraat 10, 2650, Antwerpen, Belgium. Electronic address: cecile.colpaert@gza.be.
authors.forename: C
authors.initials: C
authors.lastname: Colpaert
authors.affiliation: Department of Pathology, University Hospital Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium. Electronic address: christine.galant@uclouvain.be.
authors.forename: C
authors.initials: C
authors.lastname: Galant
authors.affiliation: Department of Pathology, University Hospital Ghent, De Pintelaan 185, 9000, Gent, Belgium. Electronic address: kathleen.lambein@ugent.be.
authors.forename: K
authors.initials: K
authors.lastname: Lambein
authors.affiliation: Department of Pathology, Regional Hospital Heilig Hart Tienen, Kliniekstraat 45, 3300, Tienen, Belgium. Electronic address: ANATOMO@rztienen.be.
authors.forename: A
authors.initials: A
authors.lastname: Cornelis
authors.affiliation: Department of Gynaecology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. Electronic address: patrick.neven@uzleuven.be.
authors.forename: P
authors.initials: P
authors.lastname: Neven
authors.affiliation: Belgian Cancer Registry, Koningsstraat 215 box 7, 1210, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van Eycken
mesh_terms: D001530:Belgium; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000378:metabolism / Q000473:pathology*; D004282:Documentation / Q000592:standards*; D047628:Estrogen Receptor alpha / Q000378:metabolism; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D060787:Neoplasm Grading; D010336:Pathology / Q000592:standards*; D011787:Quality of Health Care; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012042:Registries
chemical_list: D047628:Estrogen Receptor alpha; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011980:Receptors, Progesterone; C506487:ESR1 protein, human; C508053:ERBB2 protein, human
keywords: Breast cancer; Pathology report; Quality; Registration; Variability