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- W2893475186 abstract "Background: Histologic grade of breast cancer is a Category I prognostic factor. Thus, accurate and reproducible grading must be ensured by periodic auditing and training. Objective: The objective of this study is to audit interobserver agreement in grading and evaluate agreement of grading on core needle biopsies with surgical pathology. Materials and Methods: Slides of 73 cases of invasive carcinomas of the breast were retrieved from archives. These were grouped into 43 cases on which consensus grades assigned by 3 pathologists were compared with initial grades assigned to the cases. The next 24 cases were graded independently by 4 pathologists and compared. In the last 6 cases, consensus grades were assigned to both the initial core needle biopsy (CNB) and the excisional biopsy. Kappa values were then calculated. Results: Kappa value (κ) for the first 43 cases was 0.50 (moderate agreement; P < 0.05). There was only fair agreement (κ = 0.25) between CNB grade and final surgical pathology grade, with 50% being upgraded from Grades 2–3. There was moderate agreement (κ = 0.53, P < 0.05) in the 24 cases on which inter-rater agreement was tested. Specific rating of both mitotic count and nuclear pleomorphism showed fair agreement (κ = 0.25 and 0.34, respectively) while rating of tubule formation showed moderate agreement (κ = 0.57; P < 0.05). Pairwise kappa agreement ranged from fair to good (0.31–0.63). Conclusion: To ensure reproducibility, greater attention should be paid to accurately assessing nuclear pleomorphism and mitotic activity in particular. Re-grading of excisional breast biopsies after initial CNB is also essential to prevent undergrading." @default.
- W2893475186 created "2018-10-05" @default.
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- W2893475186 date "2017-07-01" @default.
- W2893475186 modified "2023-09-26" @default.
- W2893475186 title "Audit of nottingham system grades assigned to breast cancer cases in a Teaching Hospital" @default.
- W2893475186 doi "https://doi.org/10.4103/atp.atp_9_17" @default.
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