title: [Interobserver reproducibility in the pathologic diagnosis of borderline ductal proliferative breast diseases].
abstract: OBJECTIVE
  The aim of this study involving general pathologists was to assess interobserver reproducibility in the pathologic diagnosis of borderline ductal proliferative breast diseases.
  
  
  METHODS
  Ten general pathologists independently reviewed 43 specimens chosen to represent the spectrum of borderline ductal proliferative breast lesions. All slides were blindly reviewed without given standardized criteria, and were classified as either mild usual hyperplasia, moderate-severe usual hyperplasia, mild atypical hyperplasia, moderate-severe atypical hyperplasia, ductal carcinoma in situ, or ductal carcinoma in situ with invasion. According to the years of training, these 10 general pathologists were divided into the experienced group and the less trained group. Interobserver agreement was statistically analyzed using Kappa statistic. Then, by comparing all the diagnoses of individual pathologist with the consensus opinion confirmed by two breast pathologists in terms of Page standard, we acquired the diagnostic accuracy and ascertained the undue diagnosis.
  
  
  RESULTS
  The ten general pathologists' interobserver reproducibility in the diagnosis of borderline ductal proliferative breast diseases was rather low, especially that in their diagnosis of atypical hyperplasia. The reproducibility and accuracy were slightly higher in the experienced pathologists than in the less trained pathologists. Some pathologists made over-diagnosis or under-diagnosis of the lesions to different degrees. However, when the categories of diagnostic terms were simplified, the interobserver reproducibility increased.
  
  
  CONCLUSIONS
  The use of standardized criteria is an important approach to increasing the diagnostic reproducibility and accuracy.
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Wei
authors.forename: Hong
authors.initials: H
authors.lastname: Bu
authors.forename: Cai-rong
authors.initials: CR
authors.lastname: Zhu
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Guo
authors.forename: Hui-jiao
authors.initials: HJ
authors.lastname: Chen
authors.forename: Chun
authors.initials: C
authors.lastname: Zhao
authors.forename: Pei
authors.initials: P
authors.lastname: Zhang
authors.forename: Dai-yun
authors.initials: DY
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Tang
authors.forename: Yong
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D015588:Observer Variation; D011237:Predictive Value of Tests