A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification
Background Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic re...
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Korean Society of Pathologists & the Korean Society for Cytopathology
2021
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oai:doaj.org-article:4a2f925b5c0a421c82e2392b929534dd2021-11-18T05:29:08ZA multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification2383-78372383-784510.4132/jptm.2021.07.29https://doaj.org/article/4a2f925b5c0a421c82e2392b929534dd2021-11-01T00:00:00Zhttp://www.jpatholtm.org/upload/pdf/jptm-2021-07-29.pdfhttps://doaj.org/toc/2383-7837https://doaj.org/toc/2383-7845Background Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification. Methods Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier). Results On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems. Conclusions Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification.Hye Ju KangSun Young KwonAhrong KimWoo Gyeong KimEun Kyung KimAe Ree KimChungyeul KimSoo Kee MinSo Young ParkSun Hee SungHye Kyoung YoonAhwon LeeJi Shin LeeHyang Im LeeHo Chang LeeSung Chul LimSun Young JunMin Jung JungChang Won JungSoo Youn ChoEun Yoon ChoHye Jeong ChoiSo Yeon ParkJee Yeon KimIn Ae ParkYoungmee KwonKorean Society of Pathologists & the Korean Society for Cytopathologyarticlepapillary breast lesioncore needle biopsyinterobserver variabilityagreement ratePathologyRB1-214ENKOJournal of Pathology and Translational Medicine, Vol 55, Iss 6, Pp 380-387 (2021) |
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papillary breast lesion core needle biopsy interobserver variability agreement rate Pathology RB1-214 |
| spellingShingle |
papillary breast lesion core needle biopsy interobserver variability agreement rate Pathology RB1-214 Hye Ju Kang Sun Young Kwon Ahrong Kim Woo Gyeong Kim Eun Kyung Kim Ae Ree Kim Chungyeul Kim Soo Kee Min So Young Park Sun Hee Sung Hye Kyoung Yoon Ahwon Lee Ji Shin Lee Hyang Im Lee Ho Chang Lee Sung Chul Lim Sun Young Jun Min Jung Jung Chang Won Jung Soo Youn Cho Eun Yoon Cho Hye Jeong Choi So Yeon Park Jee Yeon Kim In Ae Park Youngmee Kwon A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| description |
Background Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification. Methods Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier). Results On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems. Conclusions Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification. |
| format |
article |
| author |
Hye Ju Kang Sun Young Kwon Ahrong Kim Woo Gyeong Kim Eun Kyung Kim Ae Ree Kim Chungyeul Kim Soo Kee Min So Young Park Sun Hee Sung Hye Kyoung Yoon Ahwon Lee Ji Shin Lee Hyang Im Lee Ho Chang Lee Sung Chul Lim Sun Young Jun Min Jung Jung Chang Won Jung Soo Youn Cho Eun Yoon Cho Hye Jeong Choi So Yeon Park Jee Yeon Kim In Ae Park Youngmee Kwon |
| author_facet |
Hye Ju Kang Sun Young Kwon Ahrong Kim Woo Gyeong Kim Eun Kyung Kim Ae Ree Kim Chungyeul Kim Soo Kee Min So Young Park Sun Hee Sung Hye Kyoung Yoon Ahwon Lee Ji Shin Lee Hyang Im Lee Ho Chang Lee Sung Chul Lim Sun Young Jun Min Jung Jung Chang Won Jung Soo Youn Cho Eun Yoon Cho Hye Jeong Choi So Yeon Park Jee Yeon Kim In Ae Park Youngmee Kwon |
| author_sort |
Hye Ju Kang |
| title |
A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| title_short |
A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| title_full |
A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| title_fullStr |
A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| title_full_unstemmed |
A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification |
| title_sort |
multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with who classification |
| publisher |
Korean Society of Pathologists & the Korean Society for Cytopathology |
| publishDate |
2021 |
| url |
https://doaj.org/article/4a2f925b5c0a421c82e2392b929534dd |
| work_keys_str_mv |
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