A new study published by the Journal of Clinical Oncology proposes that pathologic review has direct implications on lymphoma diagnosis and management.
Over a four-year span, the Lymphopath Network, a national hematopathology expert network in France that reviews lymphoma cases prior to therapeutic decision, reviewed over 30,000 samples from patients with newly diagnosed or suspected lymphoma. Researchers found that a change in diagnosis from original referral to expert review occurred in almost 20 percent of patients, and the change was significant enough to potentially impact care in over 17 percent of patients.
Diagnostic discrepancies were greater in patient samples sent with a provisional diagnosis than in those sent with a formal diagnosis, meaning that when referring pathologists were confident about the diagnosis, they were typically correct. Although most discrepancies were due to misclassifications of lymphoma subtypes, some patients were referred with benign conditions that were deemed lymphomas after pathologic review.
The study implies that frequently, in order for patients to receive optimal care, their diagnoses are best determined in collaboration with expert pathologists – especially in the current age of personalized medicine.
“As doctors who take care of people with cancer, so much of what we do is dependent on having a precise diagnosis,” said Peter Martin, Chief of the Lymphoma Program at Weill Cornell Medicine and NewYork-Presbyterian. “My bias is to meet people early on so that I can help direct the diagnostic evaluation, minimize unnecessary testing, and work with our experts in radiology, surgery, and pathology to arrive at the correct diagnosis as rapidly as possible. Importantly, the findings from the Lymphopath Network study highlight that even when a diagnosis has already been made, a second opinion regarding pathology can be important, particularly when there is any diagnostic uncertainty.”
As part of our mission to deliver precise, individualized care to as many patients as possible, expert hematologists and oncologists at the Weill Cornell Medicine and NewYork-Presbyterian Lymphoma Program collaborate with our team of world-class hematopathologists to provide collective assessment of all individual cases, working our hardest to secure an accurate diagnosis before proceeding with the appropriate therapy.