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Breast pathology guideline implementation in low- and middle-income countries†

  1. Shahla Masood MD1,‡,*,
  2. László Vass MD, PhD2,
  3. Julio A. Ibarra Jr MD3,
  4. Britt-Marie Ljung MD4,
  5. Helge Stalsberg MD5,
  6. Alexandru Eniu MD, PhD6,
  7. Robert W. Carlson MD7,
  8. Benjamin O. Anderson MD8,9,
  9. on behalf of the Breast Health Global Initiative Pathology Focus Group§

Article first published online: 3 OCT 2008

DOI: 10.1002/cncr.23833

Issue

Cancer

Cancer

Supplement: Guidelines for International Breast Health and Cancer Control–Implementation

Volume 113, Issue Supplement 8, pages 2297–2304, 15 October 2008

Additional Information

How to Cite

Masood, S., Vass, L., Ibarra, J. A., Ljung, B.-M., Stalsberg, H., Eniu, A., Carlson, R. W., Anderson, B. O. and on behalf of the Breast Health Global Initiative Pathology Focus Group (2008), Breast pathology guideline implementation in low- and middle-income countries. Cancer, 113: 2297–2304. doi: 10.1002/cncr.23833

Author Information

  1. 1

    Department of Pathology, College of Medicine– Jacksonville, University of Florida, Jacksonville, Florida

  2. 2

    Department of Pathology-Cytopathology, Flor F. University Hospital of Pest County, Budapest, Hungary

  3. 3

    Department of Pathology, Orange Coast Memorial Medical Center, Fountain Valley, California

  4. 4

    Department of Pathology, Division of Cytology, University of California at San Francisco, San Francisco, California

  5. 5

    Department of Pathology, University Hospital of North Norway, Tromsø, Norway

  6. 6

    Department of Breast Tumors, Cancer Institute “Ion Chiricuta,” Cluj-Napoca, Romania

  7. 7

    Department of Internal Medicine, Division of Medical Oncology, Stanford University, Stanford, California

  8. 8

    Department of Surgery, University of Washington, Seattle, Washington

  9. 9

    Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington

  1. ‡

    Fax: (904) 244-4060

  2. §

    The BHGI Pathology Focus Group members included Shahla Masood (Leader), László Vass, Julio A. Ibarra, Jr, Britt-Marie Ljung, Helge Stalsberg, and R.F. Chinoy (Alexandru Eniu and Robert W. Carlson as invited observers).

*Department of Pathology, University of Florida, 655 West Eighth St., First Floor Clinical Center, Jacksonville, FL 32209

  1. †

    Complete financial disclosures are presented at the end of this article.

Publication History

  1. Issue published online: 3 OCT 2008
  2. Article first published online: 3 OCT 2008
  3. Manuscript Accepted: 24 JUN 2008
  4. Manuscript Received: 10 JUN 2008

Funded by

  • Breast Health Global Initiative Global Summit
  • AstraZeneca
  • Bristol-Myers Squibb
  • Ethicon Endo Surgery
  • GE Healthcare
  • F. Hoffmann-La Roche
  • Novartis Oncology
  • Pfizer

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Keywords:

  • breast cancer diagnosis;
  • breast pathology;
  • breast health global initiative;
  • countries of limited resources;
  • quality of care;
  • breast pathology education;
  • implementation of pathology practice;
  • improved breast pathology reporting;
  • standardization of test results;
  • prognostic and predictive factors

Abstract

The quality of breast healthcare delivery and the ultimate clinical outcome for patients with breast cancer are directly related to the quality of breast pathology practices within the healthcare system. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary from October 1 to 4, 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for the early detection, diagnosis, and treatment in low-income and middle-income countries (LMCs). From this group, a subgroup of experts met to address the specific needs and concerns related to breast pathology program implementation in LMCs. Specific recommendations were made by the group and process indicators identified in the areas of personnel and training, cytology and histopathology interpretation, accuracy of pathology interpretation, pathology reporting, tumor staging, causes of diagnostic errors, use of immunohistochemical markers, and special requirements to facilitate breast conservation therapy. The group agreed that the financial burden of establishing and maintaining breast pathology services is counterbalanced by the cost savings from decreased adverse effects and excessive use of treatment resources that result from incorrect or incomplete pathologic diagnosis. Proper training in breast pathology for pathologists and laboratory technicians is critical and provides the underpinnings of programmatic success for any country at any level of economic wealth. Cancer 2008;113(8 suppl):2297–304. © 2008 American Cancer Society.

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