{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T12:03:18Z","timestamp":1775822598724,"version":"3.50.1"},"reference-count":34,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n Context.\u2014<\/jats:bold>\n A review of amended pathology reports provides valuable information regarding defects in the surgical pathology process.\n <\/jats:p>\n \n Objective.\u2014<\/jats:bold>\n To review amended breast pathology reports with emphasis placed on interpretative errors and their mechanisms of detection.\n <\/jats:p>\n \n Design.\u2014<\/jats:bold>\n All amended pathology reports for breast surgical specimens for a 5-year period at a large academic medical center were retrospectively identified and classified based on an established taxonomy.\n <\/jats:p>\n \n Results.\u2014<\/jats:bold>\n Of 12\u2009228 breast pathology reports, 122 amended reports were identified. Most (88 cases; 72%) amendments were due to noninterpretative errors, including 58 report defects, 12 misidentifications, and 3 specimen defects. A few (34 cases; 27.9%) were classified as misinterpretations, including 14 major diagnostic changes (11.5% of all amendments). Among major changes, there were cases of missed microinvasion or small foci of invasion, missed micrometastasis, atypical ductal hyperplasia overcalled as ductal carcinoma in situ, ductal carcinoma in situ involving sclerosing adenosis mistaken for invasive carcinoma, lymphoma mistaken for invasive carcinoma, and amyloidosis misdiagnosed as fat necrosis. Nine major changes were detected at interpretation of receptor studies and were not associated with clinical consequences. Three cases were associated with clinical consequences, and of note, the same pathologist interpreted the corresponding receptor studies.\n <\/jats:p>\n \n Conclusions.\u2014<\/jats:bold>\n Review of amended reports was a useful method for identifying error frequencies, types, and methods of detection. Any time that a case is revisited for ancillary studies or other reasons, it is an opportunity for the surgical pathologist to reconsider one's own or another's diagnosis.\n <\/jats:p>","DOI":"10.5858\/arpa.2016-0018-oa","type":"journal-article","created":{"date-parts":[[2016,12,13]],"date-time":"2016-12-13T16:29:55Z","timestamp":1481646595000},"page":"260-266","source":"Crossref","is-referenced-by-count":14,"title":["Quality Assurance in Breast Pathology: Lessons Learned From a Review of Amended Reports"],"prefix":"10.5858","volume":"141","author":[{"given":"Beth T.","family":"Harrison","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah A.","family":"Dillon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L.","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane E.","family":"Brock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony J.","family":"Guidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan C.","family":"Lester","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"issue":"2","key":"i1543-2165-141-2-260-b01","series-title":"Am J Clin Pathol","first-page":"238","article-title":"Amended reports: development and validation of a taxonomy of defects","volume":"130","author":"Meier \n FA,","year":"2008","unstructured":"Meier \n FA, \n \n \n Zarbo \n RJ, \n \n \n Varney \n RC, \n \n et al. \n Amended reports: development and validation of a taxonomy of defects. Am J Clin Pathol. 2008;130(2):238\u2013246."},{"issue":"5","key":"i1543-2165-141-2-260-b02","series-title":"Arch Pathol Lab Med","first-page":"617","article-title":"Medicolegal aspects of error in pathology","volume":"130","author":"Troxel \n DB.","year":"2006","unstructured":"Troxel \n DB. \n \n \n Medicolegal aspects of error in pathology. Arch Pathol Lab Med. 2006;130(5):617\u2013619."},{"issue":"10","key":"i1543-2165-141-2-260-b03","series-title":"Arch Pathol Lab Med","first-page":"1234","article-title":"An insurer's perspective on error and loss in pathology","volume":"129","author":"Troxel \n DB.","year":"2005","unstructured":"Troxel \n DB. \n \n \n An insurer's perspective on error and loss in pathology. Arch Pathol Lab Med. 2005;129(10):1234\u20131236."},{"issue":"4","key":"i1543-2165-141-2-260-b04","series-title":"Int J Surg Pathol","first-page":"335","article-title":"Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part III: breast biopsies","volume":"8","author":"Troxel \n DB.","year":"2000","unstructured":"Troxel \n DB. \n \n \n Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part III: breast biopsies. Int J Surg Pathol. 2000;8(4):335\u2013337."},{"issue":"2","key":"i1543-2165-141-2-260-b05","series-title":"Int J Surg Pathol","first-page":"161","article-title":"Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part I: general considerations","volume":"8","author":"Troxel \n DB.","year":"2000","unstructured":"Troxel \n DB. \n \n \n Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part I: general considerations. Int J Surg Pathol. 2000;8(2):161\u2013163."},{"issue":"8","key":"i1543-2165-141-2-260-b06","series-title":"Am J Surg Pathol","first-page":"821","article-title":"Problem areas in pathology practice uncovered by a review of malpractice claims","volume":"18","author":"Troxel \n DB,","year":"1994","unstructured":"Troxel \n DB, \n \n \n Sabella \n JD. \n \n \n Problem areas in pathology practice uncovered by a review of malpractice claims. Am J Surg Pathol. 1994;18(8):821\u2013831."},{"issue":"5","key":"i1543-2165-141-2-260-b07","series-title":"Arch Pathol Lab Med","first-page":"602","article-title":"Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions","volume":"138","author":"Volmar \n KE,","year":"2014","unstructured":"Volmar \n KE, \n \n \n Idowu \n MO, \n \n \n Hunt \n JL, \n \n \n Souers \n RJ, \n \n \n Meier \n FA, \n \n \n Nakhleh \n RE. \n \n \n Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions. 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Arch Pathol Lab Med. 1998;122(4):303\u2013309."},{"issue":"1","key":"i1543-2165-141-2-260-b10","series-title":"Arch Pathol Lab Med","doi-asserted-by":"publisher","first-page":"29","DOI":"10.5858\/arpa.2014-0511-SA","article-title":"Interpretive diagnostic error reduction in surgical pathology and cytology: guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the Association of Directors of Anatomic and Surgical Pathology","volume":"140","author":"Nakhleh \n RE,","year":"2015","unstructured":"Nakhleh \n RE, \n \n \n Nose \n V, \n \n \n Colasacco \n C, \n \n et al. \n Interpretive diagnostic error reduction in surgical pathology and cytology: guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the Association of Directors of Anatomic and Surgical Pathology. Arch Pathol Lab Med. 2015;140(1):29\u201340. doi:10.5858\/arpa.2014-0511-SA."},{"issue":"5","key":"i1543-2165-141-2-260-b11","series-title":"Am J Clin Pathol","first-page":"560","article-title":"Prospective peer review in surgical pathology","volume":"104","author":"Lind \n AC,","year":"1995","unstructured":"Lind \n AC, \n \n \n Bewtra \n C, \n \n \n Healy \n JC, \n \n \n Sims \n KL. \n \n \n Prospective peer review in surgical pathology. Am J Clin Pathol. 1995;104(5):560\u2013566."},{"issue":"2","key":"i1543-2165-141-2-260-b12","series-title":"Pathol Case Rev","first-page":"63","article-title":"Routine review of surgical pathology cases as a method by which to reduce diagnostic errors in a community hospital","volume":"10","author":"Novis \n D.","year":"2005","unstructured":"Novis \n D. \n \n \n Routine review of surgical pathology cases as a method by which to reduce diagnostic errors in a community hospital. Pathol Case Rev. 2005;10(2):63\u201367."},{"issue":"9","key":"i1543-2165-141-2-260-b13","series-title":"Am J Surg Pathol","first-page":"1319","article-title":"Initial experience with a novel pre-sign-out quality assurance tool for review of random surgical pathology diagnoses in a subspecialty-based university practice","volume":"34","author":"Owens \n SR,","year":"2010","unstructured":"Owens \n SR, \n \n \n Wiehagen \n LT, \n \n \n Kelly \n SM, \n \n et al. \n Initial experience with a novel pre-sign-out quality assurance tool for review of random surgical pathology diagnoses in a subspecialty-based university practice. Am J Surg Pathol. 2010;34(9):1319\u20131323."},{"issue":"5","key":"i1543-2165-141-2-260-b14","series-title":"Am J Clin Pathol","first-page":"737","article-title":"Measuring the value of review of pathology material by a second pathologist","volume":"125","author":"Renshaw \n AA,","year":"2006","unstructured":"Renshaw \n AA, \n \n \n Gould \n EW. \n \n \n Measuring the value of review of pathology material by a second pathologist. Am J Clin Pathol. 2006;125(5):737\u2013739."},{"issue":"2","key":"i1543-2165-141-2-260-b15","series-title":"Mod Pathol","first-page":"232","article-title":"Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders","volume":"26","author":"Said \n SM,","year":"2013","unstructured":"Said \n SM, \n \n \n Reynolds \n C, \n \n \n Jimenez \n RE, \n \n et al. \n Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders. Mod Pathol. 2013;26(2):232\u2013238."},{"issue":"2","key":"i1543-2165-141-2-260-b16","series-title":"Amyloid","first-page":"72","article-title":"Localized amyloidosis of the breast: a case series","volume":"18","author":"Charlot \n M,","year":"2011","unstructured":"Charlot \n M, \n \n \n Seldin \n DC, \n \n \n O'Hara \n C, \n \n \n Skinner \n M, \n \n \n Sanchorawala \n V. \n \n \n Localized amyloidosis of the breast: a case series. Amyloid. 2011;18(2):72\u201375."},{"issue":"4","key":"i1543-2165-141-2-260-b17","series-title":"Am J Clin Pathol","first-page":"606","article-title":"Addenda in pathology reports: trends and their implications","volume":"137","author":"Finkelstein \n A,","year":"2012","unstructured":"Finkelstein \n A, \n \n \n Levy \n GH, \n \n \n Cohen \n P, \n \n \n Domfeh \n A, \n \n \n Parkash \n V. \n \n \n Addenda in pathology reports: trends and their implications. Am J Clin Pathol. 2012;137(4):606\u2013611."},{"issue":"2","key":"i1543-2165-141-2-260-b01","series-title":"Am J Clin Pathol","first-page":"238","article-title":"Amended reports: development and validation of a taxonomy of defects","volume":"130","author":"Meier \n FA,","year":"2008","unstructured":"Meier \n FA, \n \n \n Zarbo \n RJ, \n \n \n Varney \n RC, \n \n et al. \n Amended reports: development and validation of a taxonomy of defects. Am J Clin Pathol. 2008;130(2):238\u2013246."},{"issue":"5","key":"i1543-2165-141-2-260-b02","series-title":"Arch Pathol Lab Med","first-page":"617","article-title":"Medicolegal aspects of error in pathology","volume":"130","author":"Troxel \n DB.","year":"2006","unstructured":"Troxel \n DB. \n \n \n Medicolegal aspects of error in pathology. Arch Pathol Lab Med. 2006;130(5):617\u2013619."},{"issue":"10","key":"i1543-2165-141-2-260-b03","series-title":"Arch Pathol Lab Med","first-page":"1234","article-title":"An insurer's perspective on error and loss in pathology","volume":"129","author":"Troxel \n DB.","year":"2005","unstructured":"Troxel \n DB. \n \n \n An insurer's perspective on error and loss in pathology. Arch Pathol Lab Med. 2005;129(10):1234\u20131236."},{"issue":"4","key":"i1543-2165-141-2-260-b04","series-title":"Int J Surg Pathol","first-page":"335","article-title":"Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part III: breast biopsies","volume":"8","author":"Troxel \n DB.","year":"2000","unstructured":"Troxel \n DB. \n \n \n Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part III: breast biopsies. Int J Surg Pathol. 2000;8(4):335\u2013337."},{"issue":"2","key":"i1543-2165-141-2-260-b05","series-title":"Int J Surg Pathol","first-page":"161","article-title":"Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part I: general considerations","volume":"8","author":"Troxel \n DB.","year":"2000","unstructured":"Troxel \n DB. \n \n \n Diagnostic errors in surgical pathology uncovered by a review of malpractice claims, part I: general considerations. Int J Surg Pathol. 2000;8(2):161\u2013163."},{"issue":"8","key":"i1543-2165-141-2-260-b06","series-title":"Am J Surg Pathol","first-page":"821","article-title":"Problem areas in pathology practice uncovered by a review of malpractice claims","volume":"18","author":"Troxel \n DB,","year":"1994","unstructured":"Troxel \n DB, \n \n \n Sabella \n JD. \n \n \n Problem areas in pathology practice uncovered by a review of malpractice claims. Am J Surg Pathol. 1994;18(8):821\u2013831."},{"issue":"5","key":"i1543-2165-141-2-260-b07","series-title":"Arch Pathol Lab Med","first-page":"602","article-title":"Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions","volume":"138","author":"Volmar \n KE,","year":"2014","unstructured":"Volmar \n KE, \n \n \n Idowu \n MO, \n \n \n Hunt \n JL, \n \n \n Souers \n RJ, \n \n \n Meier \n FA, \n \n \n Nakhleh \n RE. \n \n \n Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions. Arch Pathol Lab Med. 2014;138(5):602\u2013612."},{"issue":"5","key":"i1543-2165-141-2-260-b08","series-title":"Adv Anat Pathol","first-page":"406","article-title":"Study of amended reports to evaluate and improve surgical pathology processes","volume":"18","author":"Meier \n FA,","year":"2011","unstructured":"Meier \n FA, \n \n \n Varney \n RC, \n \n \n Zarbo \n RJ. \n \n \n Study of amended reports to evaluate and improve surgical pathology processes. Adv Anat Pathol. 2011;18(5):406\u2013413."},{"issue":"4","key":"i1543-2165-141-2-260-b09","series-title":"Arch Pathol Lab Med","first-page":"303","article-title":"Amended reports in surgical pathology and implications for diagnostic error detection and avoidance: a College of American Pathologists Q-Probes study of 1\u2009667\u2009547 accessioned cases in 359 laboratories","volume":"122","author":"Nakhleh \n RE,","year":"1998","unstructured":"Nakhleh \n RE, \n \n \n Zarbo \n RJ. \n \n \n Amended reports in surgical pathology and implications for diagnostic error detection and avoidance: a College of American Pathologists Q-Probes study of 1\u2009667\u2009547 accessioned cases in 359 laboratories. Arch Pathol Lab Med. 1998;122(4):303\u2013309."},{"issue":"1","key":"i1543-2165-141-2-260-b10","series-title":"Arch Pathol Lab Med","doi-asserted-by":"publisher","first-page":"29","DOI":"10.5858\/arpa.2014-0511-SA","article-title":"Interpretive diagnostic error reduction in surgical pathology and cytology: guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the Association of Directors of Anatomic and Surgical Pathology","volume":"140","author":"Nakhleh \n RE,","year":"2015","unstructured":"Nakhleh \n RE, \n \n \n Nose \n V, \n \n \n Colasacco \n C, \n \n et al. \n Interpretive diagnostic error reduction in surgical pathology and cytology: guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the Association of Directors of Anatomic and Surgical Pathology. Arch Pathol Lab Med. 2015;140(1):29\u201340. doi:10.5858\/arpa.2014-0511-SA."},{"issue":"5","key":"i1543-2165-141-2-260-b11","series-title":"Am J Clin Pathol","first-page":"560","article-title":"Prospective peer review in surgical pathology","volume":"104","author":"Lind \n AC,","year":"1995","unstructured":"Lind \n AC, \n \n \n Bewtra \n C, \n \n \n Healy \n JC, \n \n \n Sims \n KL. \n \n \n Prospective peer review in surgical pathology. Am J Clin Pathol. 1995;104(5):560\u2013566."},{"issue":"2","key":"i1543-2165-141-2-260-b12","series-title":"Pathol Case Rev","first-page":"63","article-title":"Routine review of surgical pathology cases as a method by which to reduce diagnostic errors in a community hospital","volume":"10","author":"Novis \n D.","year":"2005","unstructured":"Novis \n D. \n \n \n Routine review of surgical pathology cases as a method by which to reduce diagnostic errors in a community hospital. Pathol Case Rev. 2005;10(2):63\u201367."},{"issue":"9","key":"i1543-2165-141-2-260-b13","series-title":"Am J Surg Pathol","first-page":"1319","article-title":"Initial experience with a novel pre-sign-out quality assurance tool for review of random surgical pathology diagnoses in a subspecialty-based university practice","volume":"34","author":"Owens \n SR,","year":"2010","unstructured":"Owens \n SR, \n \n \n Wiehagen \n LT, \n \n \n Kelly \n SM, \n \n et al. \n Initial experience with a novel pre-sign-out quality assurance tool for review of random surgical pathology diagnoses in a subspecialty-based university practice. Am J Surg Pathol. 2010;34(9):1319\u20131323."},{"issue":"5","key":"i1543-2165-141-2-260-b14","series-title":"Am J Clin Pathol","first-page":"737","article-title":"Measuring the value of review of pathology material by a second pathologist","volume":"125","author":"Renshaw \n AA,","year":"2006","unstructured":"Renshaw \n AA, \n \n \n Gould \n EW. \n \n \n Measuring the value of review of pathology material by a second pathologist. Am J Clin Pathol. 2006;125(5):737\u2013739."},{"issue":"2","key":"i1543-2165-141-2-260-b15","series-title":"Mod Pathol","first-page":"232","article-title":"Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders","volume":"26","author":"Said \n SM,","year":"2013","unstructured":"Said \n SM, \n \n \n Reynolds \n C, \n \n \n Jimenez \n RE, \n \n et al. \n Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders. Mod Pathol. 2013;26(2):232\u2013238."},{"issue":"2","key":"i1543-2165-141-2-260-b16","series-title":"Amyloid","first-page":"72","article-title":"Localized amyloidosis of the breast: a case series","volume":"18","author":"Charlot \n M,","year":"2011","unstructured":"Charlot \n M, \n \n \n Seldin \n DC, \n \n \n O'Hara \n C, \n \n \n Skinner \n M, \n \n \n Sanchorawala \n V. \n \n \n Localized amyloidosis of the breast: a case series. Amyloid. 2011;18(2):72\u201375."},{"issue":"4","key":"i1543-2165-141-2-260-b17","series-title":"Am J Clin Pathol","first-page":"606","article-title":"Addenda in pathology reports: trends and their implications","volume":"137","author":"Finkelstein \n A,","year":"2012","unstructured":"Finkelstein \n A, \n \n \n Levy \n GH, \n \n \n Cohen \n P, \n \n \n Domfeh \n A, \n \n \n Parkash \n V. \n \n \n Addenda in pathology reports: trends and their implications. 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