title: Reproducibility in the diagnosis of needle core biopsies of non-palpable breast lesions: an international study using virtual slides published on the world-wide web.
abstract: OBJECTIVE
  To conduct an internet-based study using virtual slides (VS) of sterotactic core biopsy specimens of non-palpable breast lesions in order to evaluate interobserver reproducibility between pathologists.
  
  
  RESULTS
  A total of 18 breast lesions, determined to be histologically complex by two pathologists, were selected. Digitized VSs were then created using QuickTime Virtual Reality technology (Apple, Cupertino, CA, USA) and posted on the world-wide web. In all, 10 pathologists completed the evaluations of 18 VSs using the five diagnostic categories (B1-B5) from the European guidelines for quality assurance in breast cancer screening and diagnosis. Their results were compared with those of every other participating pathologist, and were then individually compared with the results of a highly experienced breast pathologist (referee). Of the 18 cases, 10 (56%) were classified by the referee as borderline (B3 and B4). Comparisons with reference values showed a less than satisfactory level of reproducibility (median kappa(w) = 0.60). As regards interobserver reproducibility, results showed that, in general, the level of agreement was not satisfactory (median kappa(w) = 0.53).
  
  
  CONCLUSIONS
  Overall, the findings are comparable to those quality control studies using circulating slides when analysis is done on borderline cases.
authors.affiliation: Department of Pathology, National Cancer Institute 'Giovanni Paolo II', Bari, Italy. fazito@fastwebnet.it
authors.forename: Francesco Alfredo
authors.initials: FA
authors.lastname: Zito
authors.forename: Paolo
authors.initials: P
authors.lastname: Verderio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simone
authors.forename: Vito
authors.initials: V
authors.lastname: Angione
authors.forename: Paola
authors.initials: P
authors.lastname: Apicella
authors.forename: Simonetta
authors.initials: S
authors.lastname: Bianchi
authors.forename: Antonio Felix
authors.initials: AF
authors.lastname: Conde
authors.forename: Omar
authors.initials: O
authors.lastname: Hameed
authors.forename: Julio
authors.initials: J
authors.lastname: Ibarra
authors.forename: Antony
authors.initials: A
authors.lastname: Leong
authors.forename: Natale
authors.initials: N
authors.lastname: Pennelli
authors.forename: Ezio
authors.initials: E
authors.lastname: Pezzica
authors.forename: Vania
authors.initials: V
authors.lastname: Vezzosi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ventrella
authors.forename: Sara
authors.initials: S
authors.lastname: Pizzamiglio
authors.forename: Angelo
authors.initials: A
authors.lastname: Paradiso
authors.forename: Ian
authors.initials: I
authors.lastname: Ellis
mesh_terms: D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D020407:Internet; D011642:Publications; D011786:Quality Control; D015203:Reproducibility of Results; D014481:United States