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Telecytologic diagnosis of breast fine needle aspiration biopsies. Intraobserver concordance
D Briscoe1, C F Adair, L D Thompson
1Department of Cellular Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000, USA.
Objective:
To determine the intraobserver concordance between telecytologic and glass slide diagnosis of breast fine needle aspirates.
Study Design:
Twenty-five cases, originally received in consultation, were each examined by three cytopathologists. An average of seven compressed digital images per case were presented, together with a brief clinical history, using the http protocol and an internet browser.
Results:
Agreement between the telecytologic and glass slide diagnosis ranged from 80% to 96%. Nevertheless, two cases that had been unequivocally diagnosed as malignant based upon video images were considered to be benign by the same pathologist when reviewing the glass slides. Both diagnostic confidence and self-concordance were higher for one pathologist having significant previous video microscopy experience.
Conclusion:
Although intraobserver concordance between telecytologic and glass slide diagnoses of breast fine needle aspirates is high, refinement of existing criteria for diagnosis of malignancy, taking account of the particular limitations associated with telecytologic diagnosis, may be prudent prior to widespread use of telecytology for fine needle aspiration evaluation.