title: Intraobserver Agreement on Histopathologic Evaluations of Core Breast Biopsies.
abstract: The number of performed core biopsies of the breast as diagnostic workup is increasing in many European countries. We measured the intraobserver variability in pathological assessment of breast core biopsies. Furthermore, we studied potential modifiers of agreement between the assessments. Two hundred and fifty-six breast biopsies were evaluated twice in a blinded fashion by two pathologists. We calculated the observed and the chance-corrected (weighted) intraobserver agreement (kappa) using the B-categorization scheme (B1: normal or not interpretable, B2: benign, B3: benign but of uncertain biological potential, B4: suspicious of malignancy, B5: malignant). The observed agreement between the first and the second assessments were 0.80 (95% CI: 0.75-0.85) for pathologist 1 and 0.81 (95% CI: 0.76-0.86) for pathologist 2. The chance-corrected agreements were 0.85 (95% CI: 0.80-0.89) and 0.81 (95% CI: 0.76-0.87), respectively. The most frequent disagreement was between B1 and B2 for pathologist 1 (N = 34 out of 50 disagreements, 68%) and between B2 and B3 for pathologist 2 (N = 23 out of 48 disagreements, 48%). Our study shows that the chance-corrected agreement between the histopathological evaluations of breast biopsies based on the B-categorization scheme is almost perfect. The level of agreement is modified by biopsy technique and by the level of suspicion of the mammographic lesion.
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Pietro
authors.initials: P
authors.lastname: Trocchi
authors.affiliation: Institute of Pathology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Holzhausen
authors.affiliation: Albertinen-Pathology Hamburg, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Löning
authors.affiliation: Reference Center for Gynaeco- and Mammapathology, Hamburg, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Böcker
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schmidt-Pokrzywniak
authors.affiliation: Department of Gynaecology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Thomssen
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluttig
authors.affiliation: Center of Clinical Epidemiology, c/o Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, Essen, Germany.|Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
mesh_terms: D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D000071060:Breast Density; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation
keywords: breast; classification pathology; core needle biopsy; diagnosis; reliability