272 Adherence to Breast Cancer Pathology Reporting Standards: A Retrospective Study

Introduction/Objective Standardized pathology reporting plays a crucial role in breast cancer diagnosis and guiding treatment and patient care. The College of American Pathologists (CAP) and the National Accreditation Program for Breast Centers (NAPBC) establish strict guidelines to ensure completeness and accuracy in cancer reporting. Despite these protocols, pathology reports in routine clinical practice may show inconsistencies, especially in documenting biopsy results, imaging correlation, and key biomarkers such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2). This study evaluates breast cancer pathology reports at Westchester Medical Center to assess their compliance with CAP and NAPBC standards and to identify opportunities for improvement in reporting quality and efficiency. Methods/Case Report A retrospective review was performed on pathology reports for breast cancer surgical cases at Westchester Medical Center between December 6, 2023 and March 6, 2025, using the SoftPath database. Search terms included “Breast” AND “Carcinoma” AND “Lumpectomy,” “Mastectomy,” or “Excision.” Out of 28,164 cases, 25 were selected for review (7 mastectomies, 18 lumpectomies). Reports were assessed for completeness of CAP-required data elements, ER/PR/HER-2 biomarker documentation, inclusion of biopsy results in synoptic format, and imaging-pathology correlation. Results NA Conclusion All cases included documentation of ER, PR, and HER-2 status, achieving full compliance with the CAP-required data elements. However, biopsy findings were incorporated in only 43% of mastectomy reports and 56% of lumpectomy reports. Documentation of imaging-pathology correlation was notably deficient, present in only 6% of lumpectomy reports and absent in all mastectomy reports. A significant challenge is that the CAP protocol doesn’t have a specific section to document imaging and previous biopsy studies, which may explain why this information is often missing. These gaps show a need to improve how protocols are followed and how reports are documented. Improving procedures and providing focused education on efficient documentation processes will help align reporting with CAP and NAPBC standards, ultimately enhancing patient care and the quality of breast cancer pathology reports.