How to Get the Most from Your Pathologist

Clinicians are increasingly looking to maximize the about of information gleaned from a pathology report. Beyond the final diagnosis, oncologists use the details contained in pathology reports to guide future therapy and stratify patient risk. Growing pressure to practice ‘evidence based medicine’ has led many pathologists to question the value of providing ‘soft’ data for which is there is not always good evidence to support its clinical relevance. Tumor grading schemes and evaluation of surgical margins are aspects of the surgical pathology report that particularly influence patient management. Evidence justifying tumor grading is already well established in veterinary medicine. Controlled, prospective studies evaluating margin relevance are largely lacking, and oncologists are forced to extrapolate from the human literature.

TUMOR GRADING SCHEMES

Grading schemes use histomorphologic criteria to estimate biologic behavior. In human medicine, grading schemes have effectively been used to stratify patients according to risk. These schemes have been validated by follow up data from thousands of patients. Established grading schemes now exist for a number of veterinary neoplasms – although the number of cases used to estimate behavior are considerably less.  […]