Type of publication:
Conference abstract

Author(s):
*Iles K.L.

Citation:
Journal of Pathology; Mar 2017; vol. 241, Supplement 1, Page S6

Abstract:
Forensic pathology is an important sub-specialty of pathology which requires a variety skills that are relevant and transferable to many other areas of medicine. Despite this, it does not feature in the undergraduate curriculum of most medical schools meaning that knowledge specific to forensic medicine such as wound terminology may not be taught. A lack of formal teaching and an ever increasing dramatised presence of the  specialty in the media may lead to a misrepresentation of the role of forensic pathologists. As a result this study  aimed to examine final year medical student's perceptions of the role of the forensic pathologists and their confidence in knowledge of important aspects of forensic medicine. An online survey was developed to assess these areas which was distributed to final year medical students at a UK institution via email. From the  respondents, the overall perception of the job role was correct, however there appeared to be some misconceptions regarding the role of a forensic scientist, or crime scene investigator in comparison to a forensic  pathologist. The study also highlighted that students did not feel confident in differentiating between wound  types using the correct terminology. This is important as injuries are common presentations in many clinical areas, and incorrect terminology may have mediocolegal implications. This study has highlighted the need for clarification of the job role of the forensic pathologist. There is a greater need for forensic pathology in the undergraduate curriculum, which should focus on description and terminology of wounds and injuries.

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Type of publication:
Conference abstract

Author(s):
*Lake B.; *Williams S.; *Usman T.; *Burrows C.

Citation:
European Journal of Surgical Oncology; May 2017; vol. 43 (no. 5)

Abstract:
Introduction: B3 or indeterminate breast pathology combines a variety of heterogeneous pathological entities, with varying malignant potential and often cause a treatment dilemma. Recent NHSBSP guidelines help to delineate the treatment pathway following B3 diagnosis. Recommendations include for certain B3 pathology the use of second line Vacuum Assisted Excision(VAE), which decreases the need for open surgical biopsy. The aim of this audit was to assess current practice compared to guidelines and the potential cost saving from implementation. Method: A 5 year audit of all B3 pathologies at Shrewsbury and Telford NHS Trust was performed from 2010 to 2015. Data was recorded from the Clinical Portal and included initial pathology, subsequent procedures, subsequent pathology, upgrade and downgrade rates. Cost saving analysis was performed to see how much would have been saved if the new NHSBSP guidelines had been followed. Results: 297 B3 pathologies were identified; repeat B3 biopsy and B4 pathology were excluded. Commonest initial B3 pathology was Papilloma or Papillary lesion without atypia 24%. 140 patients (47%) had excision as second line procedure. Upgrade rate was 22% and downgrade rate was 29%. Cost saving analysis showed that if VAE was available as a second line procedure, 115 patients (39%) could have had this instead of excision saving 80,960.In addition 10% of patients would have had reduced clinical pathway. Conclusion: New guidelines recommend for selected B3 pathology the use of VAE. This audit demonstrates not only does this save money but also reduces the steps in the patient's pathway.

Link to more details or full-text: http://www.ejso.com/article/S0748-7983(17)30204-4/abstract