A quality initiative of postoperative radiographic imaging performed on mastectomy specimens to reduce histology cost and pathology report turnaround time.
Breast pathology relies on gross dissection for accurate diagnostic work, but challenges can necessitate submission of high tissue volumes resulting in excess labor, laboratory costs, and delays. To address these issues, a quality initiative was created through implementation of the Faxitron PathVision specimen radiography system as part of the breast gross dissection protocol; this report documents its impact on workflow and clinical care. Retrospective data from 459 patients who underwent simple or modified radical mastectomy at our institution between May 2012 and December 2014 were collected. Comparison was made between the mastectomy specimen control group before radiography use (233 patients, 340 breasts) and Faxitron group that underwent postoperative radiography (226 patients, 338 breasts). We observed a statistically significant decrease in mean number of blocks between control and Faxitron groups (47.0 vs 39.7 blocks; P<.0001), for calculated cost savings of US $146 per mastectomy. A statistically significant decrease in pathology report turnaround time was also observed (4.2 vs 3.8days; P=.038). Postoperative mastectomy specimen radiography has increased workflow efficiency and decreased histology costs and pathology report turnaround time. These findings may underestimate actual benefits and highlight the importance of quality improvement projects in anatomical pathology.
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095. Electronic address: michael.e.kallen@gmail.com.
Michael E
ME
Kallen
Division of General Internal Medicine and Health Services Research, Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA 90095.
Myung S
MS
Sim
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095.
Bryan L
BL
Radosavcev
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095.
Romney M
RM
Humphries
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095.
Dawn C
DC
Ward
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095.
Sophia K
SK
Apple
D001940:Breast / Q000473:pathology* / Q000601:surgery; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006652:Histological Techniques / Q000191:economics / Q000379:methods; D006801:Humans; D008327:Mammography / Q000191:economics / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D010340:Pathology, Surgical / Q000191:economics / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D013048:Specimen Handling / Q000191:economics / Q000379:methods
Quality initiative; breast specimen radiography; histology cost; turnaround time