The dilemma of diagnostic drift

One dermatopathologist’s moderately dysplastic naevus is another’s melanoma in situ. And that’s not necessarily a bad thing.

Dr Blake O’Brien, a dermatopathologist with Sullivan and Nicolaides, told the Red River tale during his presentation at the recent Australian Melanoma Conference in Brisbane, to illustrate how uncertainty can lead to diagnostic drift.

“If you think that uncertainty might take you into a place where real harm might occur, if you feel that our report [to clinicians] needs to reflect that, then that encourages drift towards [diagnosing] malignancy,” Dr O’Brien said.

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