Breast screening in Singapore: implications for pathology

Area of Science:

• Pathology
• Radiology
• Oncology

Background:

• The implementation of national mammographic screening programs has significantly altered breast pathology workflows.
• Screening mammography increases the detection rate of early-stage breast lesions, including those with ambiguous histopathological features.

Purpose of the Study:

• To review the multifaceted impact of breast screening on pathology services.
• To highlight diagnostic challenges, technical considerations, and quality assurance needs arising from screening programs.

Main Methods:

• This review synthesizes current literature and expert experience concerning breast screening's effects on pathology.
• Key areas examined include specimen handling, diagnostic criteria for borderline lesions, core biopsy issues, and histological artifacts.

Main Results:

• Screening has led to a higher incidence of challenging borderline lesions and specific issues with core biopsies.
• Histological artifacts from preoperative procedures require careful recognition.
• Economic and workload implications necessitate efficient laboratory practices.

Conclusions:

• Effective management of breast screening pathology requires a multidisciplinary approach.
• Continuous professional development and robust quality assurance programs are essential for maintaining high standards in breast pathology.
• Adapting pathology services to screening demands is vital for accurate diagnosis and patient care.