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THE MULTI-DISCIPLINARY TEAM (MDT) MEETING AS A MEANS OF AUDITING BREAST CANCER HISTOPATHOLOGY REPORTS

Aim: To investigate the adequacy of histopathology reports for breast cancer cases discussed at MDT meetings at The Wollongong Hospital (TWH). Methods: Retrospective study of histopathology reports for all breast cancer cases (n = 508) discussed at MDT meetings at TWH, 2013. An amended report was attributed to an MDT meeting if it was dated the same day or later than the relevant meeting. ‘Potentially clinically significant amendments’ were those which could alter clinical decisions. Results: Amendments were made to 4.7% (n = 24/508) of reports as a result of MDT meetings. Potentially clinically significant amendments were identified in 2.0% (n = 10/508) of reports. Reasons for amendments included: omission of ancillary studies which guide treatment; discrepancy between Her2 IHC and ISH results; insufficient tissue sampling; failure to consider relevant clinico-radiological details; and inaccurately reporting, or omitting, the distance of invasive or in situ carcinoma from the nearest surgical margin. Discussion: Double review by pathologists of slides and reports could have identified most errors. Detection of a minority of errors or omissions required input from other specialists. Few studies1 have investigated the MDT meeting as a means of auditing histopathology reports of cancer, and the authors found no such study dedicated to breast cancer.