A review of breast cancer pathology reports in Nigeria

Abstract

Background Diagnosis and treatment of cancer rely heavily on imaging, histopathology and molecular information. Incomplete or missing tumour information can hinder the delivery of high-quality care in oncology practice, especially in resource-limited countries. To evaluate the completeness of histopathology reporting in a real-world setting and identify areas for future cancer care delivery research efforts, we retrospectively analysed reports from patients diagnosed with breast cancer who received care at a high-volume oncology department at a hospital in Lagos, Nigeria. Methods Demographic, institutional and histopathology characteristics were retrospectively obtained from 1,001 patient records from 2007 to 2016. Completeness was defined as reporting five tumour features (tumour histology, tumour grade, laterality, oestrogen receptor (ER) or progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2)) for biopsy specimens and seven tumour features (tumour size, tumour histology, tumour grade, laterality, ER/PR, HER2 and lymph node involvement) for surgical specimens. Results The mean age of patients was 48.6 ± 11.7 years with a predominantly female population (99.3%). A majority of pathologic reports were produced after 2011, and two-thirds of the reports originated from centres or labs within Lagos, Nigeria (67.7%). Most reports documented primary site (98.0%) and specimen type (85.0%) while other characteristics were less often recorded. This led to substantial variation in reporting between biopsy (13.4%) and surgical (6.1%) specimens for an overall low pathology report completeness <10%. Conclusion The majority of patient records analysed lacked complete documentation of breast cancer histopathological characteristics commonly used in oncology practice. Our study highlights a need to identify and address the contributing factors for incomplete histopathological reporting in Nigeria and will guide future clinical programmatic developments.

An Audit of Histopathology Reports of Invasive Breast Carcinomas with Reference to Adequacy and Amendments

“…Bilaterality (0.4%) was rare in this study similar to that reported by Yesufe et al [7], where they reported a frequency of 0.2% of bilateral tumors. Male breast cancers were reported in 1% of the cases, which was similar to studies done by Adedayo et al (0.7%) [9], Yesufe et al (4.1%) [7] and Maturi et al (0.89%) [8]. The left side breast cancers were slightly more frequent in our population, whereas right sided breast carcinomas are more commonly reported in a study by Yesufe et al [7].…”

“…The audited reports show overall completeness of the report to be 87% , which is higher than the studies by Atanda et al [11], Adedayo et al [9], Kricker et al [12], Yesufe et al [7] and Toma et al [13] where the overall report completeness for the essential parameters was 2.2%, 6.1%, 21%, 61.6% and 74.3% respectively. This could probably be explained by the fact that we have used synoptic-like format for reporting, which resulted in less chances of omission of core elements.…”