Hindawi Journal of Skin Cancer Volume 2019, Article ID 4876309, 5 pages https://doi.org/10.1155/2019/4876309
Research Article Basal Cell Carcinoma Pathology Requests and Reports Are Lacking Important Information Firas Al-Qarqaz ,1 Khaldon Bodoor,2 Awad Al-Tarawneh,3 Haytham Eloqayli ,4 Wisam Al Gargaz,5 Diala Alshiyab,1 Jihan Muhaidat,1 Mohammad Alqudah,6 Rowida Almomani,7 and Maha Marji1 1
Department of Dermatology, Jordan University of Science and Technology, P.O. Box 3030, Irbid, Jordan Department of Applied Biology, Jordan University of Science and Technology, Irbid, Jordan 3 Department of Internal Medicine and Forensic Medicine, Faculty of Medicine, Mutah University, Mu’tah, Jordan 4 Department of Neurosurgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan 5 Department of Special Surgery, Jordan University of Science and Technology, Irbid, Jordan 6 Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan 7 Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan 2
Correspondence should be addressed to Firas Al-Qarqaz;
[email protected] Received 1 October 2018; Accepted 25 December 2018; Published 3 January 2019 Academic Editor: Mark Lebwohl Copyright © 2019 Firas Al-Qarqaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Basal cell carcinoma (BCC) is the most common cancer affecting humans. Luckily it has negligible risk for metastasis; however it can be locally destructive to surrounding tissue. The diagnosis of this tumor relies on clinical and dermoscopic features; however confirmation requires biopsy and histologic examination. Based on clinical and pathologic findings, BCC is classified as low or high risk subtype. The clinician requesting pathology examination for BCC should provide the pathologist with detailed information including patient details, relevant clinical and medical history, site and type of the biopsy, and whether this is a primary or recurrent lesion. The pathologist on the other hand should write an adequate report containing a minimum of core set of parameters including type of BCC, depth of invasion, presence of lymphovascular or perineural invasion, and the excision margins. Objectives. The objective of this study is to evaluate whether requests by clinicians and pathology reports of BCC are adequate. Methods. This is a retrospective analysis done at the dermatology department, faculty of medicine at Jordan University of Science and Technology, Irbid, Jordan. Reports for the period from January 2003 to December 2017 were retrieved and analyzed for data completeness. Results. Most clinical request forms of BCC provided by clinicians are inadequate and lack important relevant information especially in regard to lesion history, patient medical history, and whether BCC is a primary or a recurrent one. Pathology reports for BCC cases also have significant deficiency especially in describing the histologic subtype, depth of invasion, and presence of lymphovascular and perineural invasion. However, the tumor excision margins are adequately described in almost all reports. Conclusions. The study shows that clinicians do not provide adequate clinical information when submitting a request for histopathologic examination of BCC. Similarly, pathologists write incomplete reports that lack important pathologic features. Having pre-set forms (electronic proforma) can help overcome missing information.
1. Introduction BCC is the most common cancer affecting populations with fair skin colors [1, 2]. Although it has almost no tendency for metastasis it still can cause significant local morbidity depending on affected site. There are several guidelines which address the various aspects of management of this common cancer [3–5].
The diagnosis of BCC can be suspected from clinical findings including rolled margins, telangiectasia, and shiny surface along with very slow growth mainly in sun-exposed sites especially in individuals with fair skin color. Additionally, dermoscopic examination can help in diagnosis with identification of one or more of dermoscopic features for BCC [6]. Confirmation of diagnosis requires histopathologic examination of biopsy [7, 8]. When submitting the request
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Journal of Skin Cancer Table 1: Data provided by clinicians in request forms. Dermatologist (N=72)
Reported data
Data provided
Other Specialties (N=263) Data absent
Data provided
p-value Data absent
