Breast cancer pathology services in sub-Saharan Africa: a survey within population-based cancer registries

Table 2 Requirements for breast cancer pathologies depending on the tier according to Sayed S. et al. [9], and Fleming KA et al. [11]

	Tier 2¹	Tier 3/ Tier 4 (Includes Tier 2 Capabilities)^2,3
Population served	50,000–200,000	3–6 million
Staff	1 general pathologist, 6 laboratory technicians and pathology assistants	4 pathologists, 2 clinical scientists, 20 technicians and pathology assistants
Communication infrastructure	Paper, electronic, or (preferred) laboratory information system	Electronic or laboratory information system
Diagnostic	Anatomic pathology: FNAC, tissue biopsies, and surgical excisions-processing, H&E stain, and interpretation	Anatomic pathology: special stains, including immunohistochemistry
Public health	Report to other registries	Hospital-based registry/ population-based registry
Accreditation	Progressing towards accreditation, such as SLIPTA	National or international accreditation, such as ISO 15189 or other
Equipment	FNAC and biopsy fixation, microscope, tissue processor, microtome for anatomic pathology, refrigerator	Automated tissue processor, immunohistochemistry station, freezer

¹ Tier 2: Laboratories in district hospitals that receive specimens from their own patients and receive referrals from tier 1 facilities
² Tier 3: Laboratories in regional or provincial hospitals that receive specimens from their own patients and receive referrals from tier 1 and 2 facilities
³ Tier 4: Laboratories in national or teaching hospitals that receive specimens from their own patients and receive referrals from tier 1, 2 and 3 facilities
Abbreviations: FNAC Fine-needle aspiration cytology, H&E Hematoxylin and Eosin, ER Estrogen, PR Progesterone, SLIPTA Stepwise Laboratory Quality Improvement Process Towards Accreditation

ISSN: 1472-6963