Comparison of first-opinion and second-opinion histopathology from dogs and cats with cancer: 430 cases (2001-2008)

Second-opinion histopathology is intended to detect clinically significant discrepancies that have a direct impact on patient care. We sought to determine if this practice at our institution affected patient management and prognosis. First- and second-opinion histopathology reports from cases were r...

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Bibliographic Details
Published in:Veterinary & comparative oncology 2010-03, Vol.8 (1), p.1-10
Main Authors: Regan, R.C, Rassnick, K.M, Balkman, C.E, Bailey, D.B, McDonough, S.P
Format: Article
Language:English
Subjects:
Animals
biopsy
cancer
cat diseases
Cat Diseases - pathology
Cats
diagnosis
diagnostic agreement
Diagnostic Errors
disease diagnosis
dog diseases
Dog Diseases - pathology
Dogs
histopathology
metastasis
neoplasia
neoplasms
Neoplasms - pathology
Neoplasms - veterinary
Observer Variation
prognosis
Referral and Consultation
second opinions
tumour
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Summary:Second-opinion histopathology is intended to detect clinically significant discrepancies that have a direct impact on patient care. We sought to determine if this practice at our institution affected patient management and prognosis. First- and second-opinion histopathology reports from cases were retrospectively reviewed. Reports were considered to be in diagnostic agreement, partial diagnostic disagreement or complete diagnostic disagreement. Four hundred and thirty cases were studied. In 70% of cases there was a diagnostic agreement. In 20% of cases, there was partial diagnostic disagreement, where diagnoses were the same but information such as grade or lymphatic and/or vascular invasion was changed. In 10% of cases, complete diagnostic disagreement resulted from a change in degree of malignancy (malignant to benign, or converse; 7%) or a change in cell type (3%). In 17% of the cases evaluated, the histopathology review prompted a change in treatment or prognosis. These findings support the use of second-opinion histopathology as an important part of patient care.
ISSN:1476-5810
1476-5829
DOI:10.1111/j.1476-5829.2009.00203.x