title: Improvement of the quality of BRAF testing in melanomas with nationwide external quality assessment, for the BRAF EQA group.
abstract: BACKGROUND
  Knowledge about tumour gene mutation status is essential for the treatment of increasing numbers of cancer patients, and testing quality has a major impact on treatment response and cost. In 2012, 4,629 tests for BRAF p.V600 were performed in France, in patients with melanomas.
  
  
  METHODS
  Two batches of unstained melanoma sections were sent, in May and November 2012, to the 46 laboratories supported by the French National Institute of Cancer (INCa). An external quality assessment (EQA) evaluated mutation status, response times and compliance with INCa recommendations.
  
  
  RESULTS
  All the French laboratories involved in testing participated in the EQA. Fourteen different methods were used to detect BRAF mutations, most consisting of combinations of in-house techniques. False responses were noted in 25/520 cases (4.8%), 11 of which concerned confusion between p.V600E and p.V600K. Thus, 2.7% of responses would have led to inappropriate treatment. Within six months, mean response times decreased from 22 to 12 days (P<0.001), and the percentage of samples evaluated by a pathologist for tumour cell content increased, from 75.2% to 96.9% (P<0.001).
  
  
  CONCLUSIONS
  Despite the use of non-certified methods, the false response rate was low. Nationwide EQA can improve the quality of molecular pathology tests on tumours.
authors.affiliation: EA4340, Versailles SQY University, Boulogne, France. jean-francois.emile@uvsq.fr.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Emile
authors.forename: Julie
authors.initials: J
authors.lastname: Tisserand
authors.forename: Loic
authors.initials: L
authors.lastname: Bergougnoux
authors.forename: Frédérique
authors.initials: F
authors.lastname: Nowak
authors.forename: Gladwys
authors.initials: G
authors.lastname: Faucher
authors.forename: Sylvie
authors.initials: S
authors.lastname: Surel
authors.forename: Aude
authors.initials: A
authors.lastname: Lamy
authors.forename: Delphine
authors.initials: D
authors.lastname: Lecorre
authors.forename: Zofia
authors.initials: Z
authors.lastname: Helias-Rodzewicz
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Sabourin
authors.forename: Pierre
authors.initials: P
authors.lastname: Laurent-Puig
mesh_terms: D003062:Codon; D004252:DNA Mutational Analysis / Q000379:methods / Q000592:standards; D005602:France; D005820:Genetic Testing / Q000379:methods / Q000592:standards*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics*; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D011786:Quality Control
chemical_list: D003062:Codon; D048493:Proto-Oncogene Proteins B-raf