Thu, 20 Apr 2017
Background: Standardized pathologic reporting of endometrial cancer allows for consistent patient diagnosis and management, and facilitates quality assurance. Reporting of benign diagnoses in endometrial biopsy currently lacks such standardization, and updated consensus terminology is needed. The Special Interest Group in Gynecologic Pathology of the Canadian Association of Pathologists embarked in the elaboration of national guidelines for benign endometrial biopsy reporting. We present the proposed document and results of internal validation through its utilization in routine biopsy evaluation.
Design: A group of 10 pathologists with expertise in gynecologic pathology and nationwide representation developed a list of the most frequent and relevant benign diagnoses encountered in endometrial biopsy. Explanatory notes and supporting references were included. A second round of review included specialists in gynecology and obstetrics, gynecologic oncology and radiation oncology. Five pathologists applied the guideline to all benign endometrial biopsies in their practices over a one-week period; biopsies with malignant or pre-malignant lesions were excluded. Number of cases in which the guideline was successfully used was recorded, as well as instances in which the guideline could not be applied satisfactorily and the diagnosis had to be recorded as free-text.
Results: The one-page consensus document included 17 possible diagnostic terms; 4 of these including optional additional information lines. During the validation step, a total of 212 benign endometrial biopsies were evaluated and reported following the guideline. The recommended terminology adequately incorporated the diagnosis in 203 cases (95.8%). In the remaining nine, the guideline could not be applied because the final diagnosis was not fully incorporated into the consensus list (5 cases, 2.3%) or due to the presence of relevant non-endometrial tissue diagnoses such as leiomyoma, myometrium and cervical tissue (4 cases, 1.9%).
Conclusions: A list of unified terminology for benign endometrial biopsy reporting is presented. Based on our validation results, the proposed guideline can successfully cover the vast majority of diagnostic scenarios. This initial validation step demonstrates that standardized reporting can be applied to benign cases and potentially improve patient care, quality assurance and research initiatives.
- Proposed Consensus Guidelines For Endometrial Biopsy Reporting Benign / Non-Neoplastic Diagnostic Categories
- Special Interest Group In Gynecologic Pathology Consensus Guidelines For Endometrial Biopsy Reporting - Part I – Benign / Non-Neoplastic Diagnostic Categories