Enhanced BMS cut up role in colonic cancer reporting

Scott A Sanders ^1*, Adrian P Smith ², Richard A Carr ², Sarah E Roberts ², Shiva Gurusamy ¹ and Emma JV Simmons ¹

¹ Coventry and Warwickshire Pathology Services, United Kingdom
² Coventry and Warwickshire Pathology services, United Kingdom

^* To whom correspondence should be addressed. E-mail: scott.sanders{at}nhs.net.

Accepted 14 July 2009

Abstract

Aims: To extend the BMS cut up role to include gastrointestinal category D colorectal cancer resection specimens and to address issues of quality and safety by presenting performance data from the first 50 BMS cut up specimens in comparison to national guidelines and pathologist performance over the same timeframe.

Methods: Close mentoring and consultant supervision was carried out for every case with adherence to standard operating procedures and following colorectal cancer dataset guidelines as published by the RCPath. Performance targets were audited including anticipated spread of Duke’s stage, targets for mean lymph node harvest, percentage extramural vascular invasion and serosal involvement, and mean tumour blocks sampled. Histological pre-reporting of 20 cases was encouraged and time spent by BMS and consultant at all stages of specimen reporting was noted.

Results: Performance targets were all exceeded by the BMS and compared favourably with pathologist performance. A measure of consultant cut up and histology reporting time saved was identified.

Conclusions: Benefits of extending the BMS role to category D specimens may include BMS professional advancement, efficient use of consultant time, and development of a team approach to cancer reporting. Achievement of colorectal cancer performance targets and favourable comparison with pathologist performance implies there was no perceived detrimental effect on quality or safety and hence patient management.