Enhanced biomedical scientist cut-up role in colonic cancer reporting

J Clin Pathol. 2012 Jun;65(6):517-21. doi: 10.1136/jclinpath-2011-200625. Epub 2012 Mar 12.

Abstract

Aims: To extend the biomedical scientist (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 with 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 Royal College of Pathologists. Performance targets were audited including anticipated spread of Dukes' 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 the development of a team approach to cancer reporting. The achievement of colorectal cancer performance targets and favourable comparison with pathologist performance implies there was no perceived detrimental effect on quality or safety and thus patient management.

MeSH terms

  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Clinical Competence / standards
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery
  • Colorectal Surgery
  • Dissection / methods
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Medical Laboratory Personnel* / standards
  • Pathology, Surgical / methods*
  • Professional Practice
  • Specimen Handling / methods*
  • Specimen Handling / standards
  • Standard of Care
  • Workforce