Variability in synoptic reporting and inclusion of essential histopathologic elements in cutaneous melanoma biopsy...

Complete, accurate melanoma pathology reports are essential for effective communication between pathologists and treating physicians. The College of American Pathologists (CAP) recommends synoptic reporting for melanoma biopsy pathology reports, while an American Academy of Dermatology (AAD) work group recommended inclusion of essential elements. We aimed to assess completeness of biopsy pathology reports according to the CAP guidelines and AAD recommendations. Biopsy reports of patients referred for invasive melanoma treatment to our academic center from 2017 to 2022 were retrospectively reviewed. Sixty-two percent of reports included all core elements outlined within the CAP guidelines, while 54% of reports included all AAD recommendations. Frequently omitted elements included margin status as well as neurotropism. Breslow depth and ulceration were included in 99% of reports. Report completeness was significantly associated with laboratory type, with the highest rates observed at academic centers and the lowest at third-party laboratories. Variability in melanoma biopsy pathology reporting remains common. Incomplete documentation, including deep margin status, may introduce uncertainty in pathologic T stage interpretation from a surgical management perspective. Wider adoption of standardized biopsy templates may improve reporting consistency, while increased awareness of biopsy report interpretation and application may reduce ambiguity and improve communication between pathologists and clinicians.