College of American Pathologists
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Unfamiliar specimens

July 2001
Karen Titus

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If a department starts to see a type of specimen that’s new to the practice, Dr. Ronald Sirota recommends a short-term revision to QA policy.

"Let’s say you start seeing stereotactic needle biopsies of the breast, and your pathologists are unfamiliar with that form of specimen," he says. "It might be a good idea to have at least one other pathologist review that type of specimen before they’re signed out, at least until the group gains experience.

"If you do it properly, you can increase group experience rapidly instead of slowly, since you’ll all be looking at many of the same types of cases in a relatively short amount of time," he continues. And when the group’s experience is sufficient, "you can simply drop the requirement."

When his practice began seeing spring-loaded prostate needle biopsies in the early 1990s, "We found those specimens to be very difficult," he recalls, mostly because of the drop in tissue volume. "We decided at least one other pathologist, if not more, had to look at these cases." The requirement was kept in place for well over a year, he says. "Now it’s optional."