Josh Friedman , 2025-04-18 15:33:00
April 18, 2025
4 min read
Key takeaways:
- Women with breast pathology derived benefit from consultation with a pathologist.
- The telehealth meetings lasted 30 minutes and included a review of biopsy results.
Women who spoke with a pathologist about their breast pathology as part of a pilot program reported having better understanding of their tests and feeling empowered in their health care journey, according to survey results.
The program, started at Sylvester Comprehensive Cancer Center in 2024, gave patients the opportunity to speak with a specialist about both benign and malignant pathology to improve their understanding of images and decrease stress and anxiety.
Researchers presented results at the USCAP Annual Meeting in March.
“What this program is highlighting is how we can all reach across the aisle and impact care in a very patient-centered way,” Jose M. Net, MD, director of breast imaging services at Sylvester Comprehensive Cancer Center, associate professor of clinical radiology at University of Miami Miller School of Medicine and collaborator on the project, told Healio.
Background
Traditionally, pathologists do not interact with patients, Net said. Instead, pathologists go over results with the care team, who then pass that information onto patients.
Pathologists have been referred to as “the doctor’s doctor.”
“It’s an effective way to do medicine,” Net said.
Radiologists typically operate in a similar manner as pathologists. They discuss imaging and make treatment recommendations to providers, who convey that information to patients.
At Sylvester, Net has had the opportunity to interact with patients more directly.
“When I’m on clinic, I’m in an actual physical clinic where I have exam rooms,” he said. “I go and talk to my patients. I get their histories. I do exams where needed. I do my own targeted scanning when I need to do it. When I have to do biopsies, I can do it all very personalized to the patient.”
The pathology department reached out to Net with the idea to take a similar approach.
“I thought it was a great idea,” Net said. “I was very excited to participate because it’s further expanding the roles of all these physicians people don’t really see who are so important to their care.”
Methods
In “The doctor’s doctor is the patient’s doctor! A patient care quality improvement study,” radiologists and surgeons gave individuals with breast pathology a choice to speak with a pathologist about their results.
In all, 36 women (median age, 56 years; range, 36-79) received the offer for a 30-minute telehealth visit to review pathology slides.
Of those, 20 patients (56%) were scheduled for a 30-minute consultation and 13 (65%) of them attended.
Most participants (53%) had benign lesions.
After the consultation, participants completed a survey about their experience, which included six questions:
- Did you think there was enough time to address your questions and concerns?
- Was the description of your biopsy results with the pathologist presented in language that was clear and understandable to you?
- Did viewing your slides give you a better understanding of your results?
- Now that you have seen your biopsy “face-to-face,” do you feel more empowered in managing your health care journey?
- Would you be interested in coming back for multiple consultation sessions as part of your treatment management?
- Would you recommend the experience to another patient?
Participants had five response options: strongly agree, agree, neither agree or disagree, disagree or strongly disagree.
Self-reported survey results about the consultation served as the primary endpoint.
Results, next steps
All participants “strongly agreed” with every question in the survey except one woman who said she neither agreed nor disagreed about wanting to come back for another consultation.
One patient called the program “excellent” and another described it as “reassuring,” according to researchers.
Other comments included:
- “This is the best program offered by any cancer center I have been to. It was incredibly helpful to discuss my particular cell morphology directly with the pathology team. What a fantastic opportunity for an informed patient.”
- “This team was confidence inspiring. Please understand that not every patient will benefit by this but for those [who] seek out this information, the program is invaluable. I am very grateful to the entire team.”
- “This interview should be included in all protocols.”
- “We feel so much better now that we understand what we are dealing with.”
“Getting to partake in a consultation where a patient has the opportunity to delve into topics that are important to them — and have a subspecialty expert explain typically complex medical jargon in very digestible terms — has extended and expanded what it is we’re doing in the mission to develop better ways of patient-centered medicine,” Net said. “It’s really great to see a patient have that opportunity.”
Net noted that women who had benign lesions seemed to have more interest in consults.
“Once they’ve gone through a biopsy, and we tell them it’s nothing, they inevitably have questions like, ‘Can this turn into cancer? Does it increase my risk of cancer?’” Net said. “Having the pathologist support and delve into why these findings are benign on a cellular level has been great to see. It’s been a huge benefit to the patients who have enjoyed the service.”
Other institutions could replicate this initiative, Net said. The positive results also could allow Sylvester to expand the program, though resources could be a barrier.
“They would need more people to be able to roll this out to everyone,” Net said. “I think that would be the only hurdle. Hopefully those resources are forthcoming if we can prove that it really does yield the type of quality impression that a patient in our center should aspire for.”
References:
For more information:
Jose M. Net, MD, can be reached at jnet@med.miami.edu.