The quality of pathology service relies on three fundamentals:
1. The experience and confidence of the pathologist
The minimum criteria to diagnose the malignancy are present at a single gland level. Among so many mimicking benign lesions, it is hard to make a definite call even for the experts let aside the inexperienced pathologists. Numerous studies are present addressing this aspect of the service, comparing the results of large hospitals, general pathologists with those of experts. According to these studies about 10% of the biopsy reports have major errors impacting the patient healthcare.
2. The quality of the histotechnology methods and their application
The quality of a lab is measured by the difference at length of the tissue on the slide and of the tissue in the formalin jar. So it is the art of preserving the tissue 100% as is submitted. Unfortunatey, the tiny fragile isolated fragments harbor cancer more often than presumed. Even at the hand of the most experienced pathologists, prostate cancer is easily missed if the core(s) is not entirely submitted, embedded, sectioned and stained properly. Controlling the quality of histotechnologist is difficult in large labs since they process enormous numbers of prostate biopsies per day per technician. The technicians simply pick up the piece they like from the formalin bottle. They embed them into paraffin the way it looks easy. In sectioning they just take a section that looks good to them. One needs to maintain the quality while making four slides per block times twelve per case and times 2-3 hundreds of cases a day. Few data in literature is available discussing the impact of the quality of histotechnology in prostate biopsy. The best one I found is presented here from the Journal of Clinical Pathology.
3. The quality of the office service
Communication, transportation, specimen-tracking and labeling are all examples of the quality we deliver. The pathologist and the office are available for 24 hours a day 7 days a week.