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.
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.
Zito
Francesco Alfredo
FA
Department of Pathology, National Cancer Institute 'Giovanni Paolo II', Bari, Italy. fazito@fastwebnet.it
Verderio
Paolo
P
Simone
Giovanni
G
Angione
Vito
V
Apicella
Paola
P
Bianchi
Simonetta
S
Conde
Antonio Felix
AF
Hameed
Omar
O
Ibarra
Julio
J
Leong
Antony
A
Pennelli
Natale
N
Pezzica
Ezio
E
Vezzosi
Vania
V
Ventrella
Vincenzo
V
Pizzamiglio
Sara
S
Paradiso
Angelo
A
Ellis
Ian
I
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