title: Interobserver agreement among pathologists for semiquantitative hormone receptor scoring in breast carcinoma.
abstract: The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines recommend reporting of hormone receptor test results in a semiquantitative manner. This study used 74 resected estrogen receptor (ER)-positive invasive breast cancers to determine reproducibility of semiquantitative scoring of hormone receptors using the H-score method. Four pathologists independently scored each slide. Agreement among observers was analyzed via Fleiss κ statistics on ER and progesterone receptor (PR) categorical scores. Intraclass correlation coefficient (ICC) was used to estimate the interobserver agreement for ER and PR H-scores on a continuous scale (0-300). There was 100% agreement for categorical ER results (κ = 1) and 97% agreement (κ = 0.823, P < .001) for categorical PR results. For quantitative H-scores, ICC agreement was 0.85 (95% confidence interval [CI] = 0.79-0.90) for ER and 0.87 (95% CI = 0.82-0.92) for PR. Because the H-score provides a continuous measure of tumor hormone receptor content, we suggest universal adoption of this method.
authors.affiliation: Department of Pathology, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Cohen
authors.forename: David J
authors.initials: DJ
authors.lastname: Dabbs
authors.forename: Kristine L
authors.initials: KL
authors.lastname: Cooper
authors.forename: Milon
authors.initials: M
authors.lastname: Amin
authors.forename: Terrell E
authors.initials: TE
authors.lastname: Jones
authors.forename: Mirka W
authors.initials: MW
authors.lastname: Jones
authors.forename: Mamatha
authors.initials: M
authors.lastname: Chivukula
authors.forename: Giuliana A
authors.initials: GA
authors.lastname: Trucco
authors.forename: Rohit
authors.initials: R
authors.lastname: Bhargava
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015588:Observer Variation; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D015203:Reproducibility of Results
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone