Errors in prostate core biopsy diagnosis in an era of specialisation and double reporting

• Published in: Journal of clinical pathology Vol. 74; no. 5; pp. 327 - 330
• Main Authors: Szecsei, Cornelia Margaret, Oxley, Jon D
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.05.2021; BMJ Publishing Group LTD
• Subjects: Adenocarcinoma - pathology; Audits; Biopsy; Biopsy, Large-Core Needle; carcinoma; clinical audit; Consultants; diagnosis; False Negative Reactions; False Positive Reactions; Humans; Male; Medical diagnosis; Medical errors; morphological and microscopic findings; Multidisciplinary teams; Pathologists; Pathology; Predictive Value of Tests; prostate; Prostate cancer; Prostatic Neoplasms - pathology; Referral and Consultation; Reproducibility of Results; Short report; Specialization; United Kingdom > UK; clinical audit; diagnosis; prostate; carcinoma; morphological and microscopic findings
• ISSN: 0021-9746; 1472-4146; 1472-4146
• DOI: 10.1136/jclinpath-2020-206726

AimTo examine the effects of specialist reporting on error rates in prostate core biopsy diagnosis.MethodBiopsies were reported by eight specialist uropathologists over 3 years. New cancer diagnoses were double-reported and all biopsies were reviewed for the multidisciplinary team (MDT) meeting. Diagnostic alterations were recorded in supplementary reports and error rates were compared with a decade previously.Results2600 biopsies were reported. 64.1% contained adenocarcinoma, a 19.7% increase. The false-positive error rate had reduced from 0.4% to 0.06%. The false-negative error rate had increased from 1.5% to 1.8%, but represented fewer absolute errors due to increased cancer incidence.ConclusionsSpecialisation and double-reporting have reduced false-positive errors. MDT review of negative cores continues to identify a very low number of false-negative errors. Our data represents a ‘gold standard’ for prostate biopsy diagnostic error rates. Increased use of MRI-targeted biopsies may alter error rates and their future clinical significance.