The College of American Pathologists (CAP) has updated its breast cancer reporting protocols to incorporate the latest World Health Organization (WHO) classifications and recommendations, introducing revisions intended to align pathology reporting with the WHO Classification of Breast Tumours, 6th Edition.
The Q2 2026 release includes updates to eight CAP Cancer Protocols, with the most extensive changes affecting ductal carcinoma in situ (DCIS) and invasive breast cancer biopsy and resection protocols. According to CAP, the revisions include changes to tumor characterization, grading, assessment of disease extent, and reporting of additional lesions.
The updated protocols reflect current classification criteria and are intended to support consistent synoptic reporting for breast cancer diagnosis, staging, and treatment planning. Standardized reporting also helps ensure that key diagnostic and prognostic data are captured in pathology reports.
"By incorporating the latest WHO recommendations, these updates help pathologists deliver accurate, complete, and standardized cancer synoptics," said M. E. de Baca, MD, Chair of the CAP's Council on Informatics and Pathology Innovation. "Consistent, high-quality reporting ensures patient safety, informs treatment decisions, and promotes the highest standard of care."
Beyond breast cancer, the release includes refinements to kidney cancer protocols, including updates to tumor grading and simplified tumor size reporting, as well as revisions to protocols for HPV-associated oropharyngeal carcinoma and mucosal melanoma.
Several of the changes included in the Q2 release are required for laboratory accreditation and may have associated implementation timelines. Laboratories adopting protocols that incorporate the WHO updates should review the corresponding accreditation effective dates. CAP has also published a summary of all revisions included in the release.
CAP updates its Cancer Protocols quarterly to reflect guidance from organizations including the WHO and the American Joint Committee on Cancer (AJCC). The protocols provide evidence-based reporting templates that support cancer diagnosis, staging, and communication of clinically relevant findings between pathologists and treating clinicians.
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