Don't trust – check
Scientists: a quarter of laboratories in Russia poorly diagnose breast cancer
The first large-scale inspection of Russian immunohistochemistry laboratories showed that a quarter of them often make incorrect diagnoses when looking for traces of mutations associated with the development of breast cancer. This is reported by the Center for Quality Control of IHC Research of FSBEI DPO RMANPO (this unpronounceable abbreviation means "Federal State Budgetary Educational Institution of Additional Professional Education Russian Medical Academy of Continuing Postgraduate Education" – VM.
"In diseases such as breast cancer, rectal cancer or lung cancer, the quality of IHC studies is especially important for establishing the correct diagnosis and choosing treatment tactics. Passing quality control will help laboratories to monitor and improve the quality of services provided," said Academician Georgy Frank, chief freelance specialist pathologist of the Ministry of Health of Russia.
To date, breast cancer remains the most common type of malignant tumors among women. According to WHO estimates, about 500 thousand women die from it every year. The problem with the treatment of breast cancer is that the detection of breast cancer in the early stages of development is difficult due to the imperfection of diagnostic methods - mammography correctly detects it only in 12% of cases.
Genetic studies in recent years show that breast tumors most often develop in women who are carriers of mutations in a small set of genes, such as HER2, BRCA, ESR1 and a number of other DNA sites responsible for repairing damaged chromosomes and "self-destruction" of cells in case of fatal genome breakdown.
Knowing exactly which genes contain damage is extremely important for the selection of therapy in the treatment of cancer, since different sets of mutations significantly change how cancer cells respond to chemotherapy.
On the territory of Russia, as Frank noted, today there are several dozen IHC laboratories stating that they have the capabilities for early diagnosis of various types of breast cancer and search for traces of mutations in these genes.
In April of this year, Frank and other specialists of the Quality Control Center conducted the first large-scale inspection of their work, checking how well 29 regional laboratories cope with the search for mutations in the ESR1 and HER2 genes, which are associated with some of the most aggressive forms of breast cancer.
As it turned out, in the first case, serious mistakes were made in 26% of laboratories, and in the second – in 19% of them. In general, this is quite a good indicator – about 29% of IHC laboratories in Britain, France and the USA have serious problems in their work.
Scientists hope that such checks will help Russia reach the Western level in the quality of early cancer diagnosis and patient survival, which is about 70% today. In Russia, this indicator is still significantly lower – 56% and 54%. As experts' observations show, both are growing quite rapidly – for example, the quality of cancer detection increased by 3.4% last year alone.
The Center will conduct the next round of quality control in the fourth quarter of this year. It will be devoted to markers used in the diagnosis of lung cancer associated with the genes KRT7, KRT5/6, TTF1.
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