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Editor's e-Note
Diagnostic errors resulting from pathological assessment of biopsies for skin lesions and cancer occur at high rates. According to UCLA researchers, a second opinion from board-certified pathologists or those with fellowship training in dermatopathology can increase the accuracy of diagnoses.

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— Kate Jackson, editor
e-News Exclusive
Increasing Confidence in Melanoma Diagnosis

Getting a reliable diagnosis of melanoma can be a significant challenge for pathologists. The diagnosis relies on a pathologist’s visual assessment of biopsy material on microscopic slides, which can often be subjective. Of all pathology fields, analyzing biopsies for skin lesions and cancers has one of the highest rates of diagnostic errors, affecting millions of people each year.

Now, a new study led by UCLA researchers has found that obtaining a second opinion from pathologists who are board certified or have fellowship training in dermatopathology can help improve the accuracy and reliability of diagnosing melanoma, one of the deadliest and most aggressive forms of skin cancer.

“A diagnosis is the building block on which all other medical treatment is based,” says Joann Elmore, MD, MPH, a professor of medicine at the David Geffen School of Medicine at UCLA and researcher at the UCLA Jonsson Comprehensive Cancer Center. “On the other end of these biopsies are real patients: patients answering the late-night, anxiety-inducing phone calls when we inform them of their diagnosis; patients undergoing invasive surgeries; patients weighing their next clinical steps. All patients deserve an accurate diagnosis. Unfortunately, the evaluation and diagnosis of skin biopsy specimens is challenging, with a lot of variability among physicians.”

In the study, led by Elmore and her colleagues, the value of a second opinion by general pathologists and dermatopathologists was evaluated to see whether it helped lead to the correct diagnostic classification.

Full story »
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