Abstract P5-15-01: The value of patient-pathologist consultation for breast cancer patients
Authors: Stoos Catherine T , Hunley Kate A. , Cronin Laurrie , Walters Ryan 
Published: March 2022

Abstract
Introduction: Tissue diagnoses of breast cancer are made by pathologists, who generally do not interact with patients directly. A patient's diagnosis and related information is generally delivered second-hand by a treating clinician. As pathologists are able to explain how a diagnosis of breast cancer is made on a biopsy, and why and how malignant diseases are different from “normal” tissue, a patient-pathologist consultation may be a valuable option for educating the patient. In our study, we evaluate the value, if any, patient-pathologist consultations may have for patients with a diagnosis of breast cancer. Methods: Patients with a diagnosis of invasive breast carcinoma or ductal carcinoma in-situ (DCIS) were recruited to participate in a free, one-on-one patient-pathologist consultation. During the consultation, information within the patient's pathology report, breast cancer-related pathogenesis and terms, and breast biomarker immunohistochemistry were discussed. The patient was able to review their own specimen slides with the pathologist. Pre- and post-consultation surveys were administered to measure the patient’s perceived knowledge of terminology related to their diagnosis, their anxiety regarding their understanding of their diagnosis, whether they were able to mentally picture their tumor, and to measure overall satisfaction. Results: Twenty (20) female patients were recruited into the study, with a median age of 58 years. Thirteen (13) of the 20 patients (65%) had a diagnosis of invasive carcinoma (10 invasive ductal carcinoma (IDC), 2 invasive lobular carcinoma (ILC), and 1 both IDC and ILC), and 7 patients (35%) had a diagnosis of ductal carcinoma in-situ (DCIS). Pre- and post-consultation survey data showed significant increases in the patients’ perceived understanding of medical terminology related to their diagnosis following the consultation, decreases in perceived anxiety related to the understanding of their diagnosis following the consultation, and patients reported that they were able to mentally picture their tumor (Table 1). With regard to general satisfaction with the consultation, all patients believed meeting with a pathologist was valuable, and all would recommend the consultation to a family member or friend with a breast cancer diagnosis. Free-text comments were provided by 9 patients, which showed with favorable comments. Discussion and Limitations: Our results suggest that patient-pathologist consultation may be valuable to breast cancer patients. Following the consultation, patients reported less anxiety regarding the understanding of their diagnosis, were able to mentally picture their tumor, and reported a better understanding of medical terminology related to their diagnosis. There were several limitations to our study. Most consultations were provided by a single pathologist with fellowship training in breast pathology. Secondly, we had a small sample size and all participants were female. Finally, the surveys could only measure patient's short-term perception of perceived knowledge gains or lessened anxiety regarding their understanding of their diagnosis. Aside from these limitations, we feel patient-pathologist consultation for breast cancer patients, if included as part of their care, would help demystify their diagnosis and further empower the patient by increasing their knowledge of their diagnosis.
Table 1.Pre- and Post-consultation Survey DataQuestion NumberQuestionPre-consultationPost-consultationp1Understanding of medical terminology related to diagnosis4 [4-7]9 [8-9]&lt;.0012Anxiety related to understanding of diagnosis8 [5-9]3 [2-5]&lt;.0013Understanding of tumor "grade"5 [3-7]9 [8-9]&lt;.0014Understanding of biomarkers5 [2-7]9 [8-9]&lt;.0015Understanding of tumor "stage"6 [4-6]9 [8-9]&lt;.0016What "malignant" means and how it relates to diagnosis8 [5-9]9 [9-10]&lt;.0017Understanding of "invasive" versus "in-situ"5 [4-7]10 [9-10]&lt;.0018Understanding of " ductal" versus "lobular"4 [3-7]9 [9-10]&lt;.0019Patient can mentally picture what tumor looks like3 [2-7]9 [9-10]&lt;.001Data presented as median [interquartile range].Statistical comparisons were made using the sign test.
Citation Format: Catherine T Stoos, Kate A. Hunley, Laurrie Cronin, Ryan Walters. The value of patient-pathologist consultation for breast cancer patients [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-15-01.