Consistency in the observation of features used to classify duct carcinoma in situ (DCIS) of the breast

被引:38
作者
Douglas-Jones, AG
Morgan, JM
Appleton, MAC
Attanoos, RL
Caslin, A
Champ, CS
Cotter, M
Dallimore, NS
Dawson, A
Fortt, RW
Griffiths, AP
Hughes, M
Kitching, PA
O'Brien, C
Rashid, AM
Stock, D
Verghese, A
Williams, DW
Williams, NW
Williams, S
机构
[1] Univ Wales Coll Med, Dept Pathol, Cardiff CF4 4XN, S Glam, Wales
[2] Worthing Hosp, Dept Pathol, Worthing BN11 2DH, W Sussex, England
[3] Llandough Hosp, Dept Pathol, Penarth CF64 2XX, S Glam, Wales
[4] Ysbyty Gwynedd, Dept Pathol, Bangor LL57 2PW, Gwynedd, Wales
[5] E Glamorgan Gen Hosp, Dept Pathol, Church Village CF38 1AB, Nr Pontypridd, Wales
[6] Morriston Hosp, Dept Pathol, Swansea SA6 6NL, W Glam, Wales
[7] Royal Gwent Hosp, Dept Pathol, Newport, Gwent, Wales
[8] Royal United Hosp, Dept Pathol, Bath BA1 3NG, Avon, England
[9] Royal United Hosp, Dept Pathol, Bath BA1 3NG, Avon, England
[10] Prince Philip Hosp, Dept Pathol, Llanelli SA14 8QF, Dyfed, Wales
[11] Singleton Hosp, Dept Pathol, Swansea SA2 8QA, W Glam, Wales
关键词
classification; duct carcinoma in situ; breast; intraduct necrosis;
D O I
10.1136/jcp.53.8.596
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Aim-To determine interobserver and intra-observer agreement in the assessment of cytological grade and intraduct necrosis in pure duct carcinoma in situ (DCIS) of the breast. Methods-Sixty unselected cases with illustrated diagnostic criteria were circulated to 19 practising histopathologists. Results-Overall agreement was moderate for cytological grade in three categories: 71% agreement; weighted kappa (kappa w), 0.36; intraduct necrosis in three categories (absent, present, extensive): 76% agreement; kappa w 0.57; and the Van Nuys classification system: 73% agreement; kappa w, 0.48. Agreement was no better among observers participating in the National External Quality Assurance Programme. Intra-observer agreement for cytological assessment (69.6% agreement; kappa w, 0.52) and intraduct necrosis (68.3% agreement; kappa w, 0.48) was moderate, suggesting that individual variation rather than precision of criteria contributes to the lack of agreement. Conclusions-Moderate agreement on observations can be achieved by non-specialist pathologlsts, with better agreement on necrosis than cytological grade. There was evidence of consistent individual bias towards over or under scoring cytological grade, which could be corrected with adequate and prompt feed-back.
引用
收藏
页码:596 / 602
页数:7
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