[Interobserver reproducibility in the pathologic diagnosis of borderline ductal proliferative breast diseases].
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.
Wei
Bing
B
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
Bu
Hong
H
Zhu
Cai-rong
CR
Guo
Li-xin
LX
Chen
Hui-jiao
HJ
Zhao
Chun
C
Zhang
Pei
P
Chen
Dai-yun
DY
Tang
Ying
Y
Jiang
Yong
Y
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