title: Web based pathology assessment in RTOG 98-04.
abstract: OBJECTIVE
  Radiation Therapy Oncology Group 98-04 sought to identify women with ‘good risk’ ductal carcinoma in situ (DCIS) who receive no significant benefit from radiation. Enrolment criteria excluded close or positive margins and grade 3 disease. To ensure reproducibility in identifying good risk pathology, an optional web based teaching tool was developed and a random sampling of 10% of submitted slides were reviewed by a central pathologist.
  
  
  METHODS
  Submitting pathologists were asked to use the web based teaching tool and submit an assessment of the tool along with the pathology specimen form and DCIS H&E stained slide. Per protocol pathology was centrally reviewed for 10% of the cases.
  
  
  RESULTS
  Of the 55 DCIS cases reviewed, three had close or positive margins and three were assessed to include grade 3 DCIS, therefore 95% of DCIS cases reviewed were correctly graded, and 89% reviewed were pathologically appropriate for enrolment. Regarding the teaching tool, 13% of DCIS cases included forms that indicated the website was used. One of these seven who used the website submitted DCIS of grade 3.
  
  
  CONCLUSIONS
  Central review demonstrates high pathological concordance with enrolment eligibility, particularly with regard to accurate grading. The teaching tool appeared to be underused.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Nour
authors.initials: N
authors.lastname: Sneige
authors.forename: Kathryn
authors.initials: K
authors.lastname: Winter
authors.forename: Henry Mark
authors.initials: HM
authors.lastname: Kuerer
authors.forename: Clifford
authors.initials: C
authors.lastname: Hudis
authors.forename: Eileen
authors.initials: E
authors.lastname: Rakovitch
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Smith
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Pierce
authors.forename: Isabelle
authors.initials: I
authors.lastname: Germano
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Pu
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Walker
authors.forename: David Lawrence
authors.initials: DL
authors.lastname: Grisell
authors.forename: Julia R
authors.initials: JR
authors.lastname: White
authors.forename: Beryl
authors.initials: B
authors.lastname: McCormick
mesh_terms: D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D003194:Computer-Assisted Instruction; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008327:Mammography; D060787:Neoplasm Grading; D010338:Pathology, Clinical / Q000193:education*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden