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Low-Grade Ductal Carcinoma In Situ
Sarah A Alghamdi1, Kritika Krishnamurthy2, Sofia A Garces Narvaez2
1University of Miami/Jackson Health System, Miami, FL.
American Journal of Clinical Pathology
|November 27, 2019
Summary
Pathologists showed moderate agreement in diagnosing low-grade ductal carcinoma in situ (DCIS). A proposed two-tiered grading system improved concordance compared to the traditional three-tiered system for DCIS.
Area of Science:
- Pathology
- Oncology
- Breast Cancer Diagnosis
Background:
- Interobserver reproducibility is crucial for accurate cancer diagnosis.
- Grading systems for ductal carcinoma in situ (DCIS) aim to standardize assessment.
- Current three-tiered grading systems may have limitations in reproducibility.
Purpose of the Study:
- To assess interobserver reproducibility in diagnosing low-grade ductal carcinoma in situ (DCIS).
- To compare the interobserver variability between a proposed two-tiered grading system and the current three-tiered system for low-grade DCIS.
Main Methods:
- Three expert and one junior breast pathologists reviewed 300 DCIS slides.
- Pathologists initially identified low-grade DCIS.
- Subsequently, they graded the cases using both the standard three-tiered and a proposed two-tiered system.
Main Results:
- Moderate interobserver agreement (κ = 0.575) was observed using the two-tiered system.
- Agreement remained moderate (κ = 0.532) with the inclusion of a junior pathologist.
- Poor agreement (κ = 0.235) was found when using the three-tiered system.
Conclusions:
- Pathologists demonstrated moderate reproducibility in diagnosing low-grade DCIS.
- Pathologist experience did not significantly influence reproducibility.
- The proposed two-tiered system (low vs. nonlow grade) showed improved concordance for DCIS grading.
