Interobserver Variability on Breast Core Biopsy

Radiya Al-Ajmi, Hunaina Al-kindi, Mina George, Ruqaiya Al-Shamsi, Syed Rizvi


Grading of breast cancer based on certain histological features plays a precious role in predicting the prognosis and the outcomes of this prevalent neoplasm.
This study evaluates the degree of agreement on grading invasive ductal carcinoma on breast core biopsy among general pathologists.
Breast core biopsies of 27 patients with invasive ductal carcinoma were independently evaluated by three pathologists and graded according to the Bloom and Richardson (Nottingham modification) grading system. A detailed histopathological assessment was carried out and analyzed statistically.
The results showed a substantial agreement among the three pathologists in final grading of breast core biopsies (Kappa= 0.819, 0.690 & 0.757 and P<0.0005). The same trend of agreement was also observed in scoring mitosis (Kappa= 0..859, 0.765 & 0.654 and P< 0.0005), and nuclear pleomorphism (Kappa = 0.538, 0.505 & 0.535 and P< 0.0005). Fair agreement was noted in scoring tubule formation (Kappa = 0.456, 0.382 & 0.428 and P < 0.01).
This study reveals that despite the presence of individual difference in evaluating some of the parameters of the grading system, there was a substantial agreement between the participated pathologists in the final grading of breast carcinoma in core biopsies.

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