BACKGROUND: Current guidelines include a recommendation that a pathologist with expertise in breast disease review all ductal carcinoma in situ (DCIS) specimens due to the presence of significant variability in pathologic reporting of DCIS. The objective of this study was to evaluate the completeness and accuracy of pathologic reporting of DCIS over the past decade and to determine the current impact of expert breast pathology assessment on the management of DCIS. METHODS: All patients with a diagnosis of DCIS referred to a single regional cancer centre between 1982 and 2000 have been reviewed. Inter-observer variability between initial and secondary reports has been evaluated using kappa statistics. For each case, the Van Nuys Prognostic Index (VNPI) using pathologic data obtained from the initial and reviewed pathology reports were compared. The impact of expert breast pathology on risk assessment and treatment was determined. RESULTS: 481 individuals with DCIS were referred and pathology review was performed on 350 patients (73%). Inter-observer agreement was high for the main pathologic features of DCIS. From 1996 to 2000, secondary pathology assessments lead to a change in the assessment of local recurrence risk in 100 cases (29%) and contributed to a change in treatment recommendation in 93 (43%) cases. CONCLUSION: Expert breast pathology assessments continue to be necessary in the management of DCIS.
BACKGROUND: Current guidelines include a recommendation that a pathologist with expertise in breast disease review all ductal carcinoma in situ (DCIS) specimens due to the presence of significant variability in pathologic reporting of DCIS. The objective of this study was to evaluate the completeness and accuracy of pathologic reporting of DCIS over the past decade and to determine the current impact of expert breast pathology assessment on the management of DCIS. METHODS: All patients with a diagnosis of DCIS referred to a single regional cancer centre between 1982 and 2000 have been reviewed. Inter-observer variability between initial and secondary reports has been evaluated using kappa statistics. For each case, the Van Nuys Prognostic Index (VNPI) using pathologic data obtained from the initial and reviewed pathology reports were compared. The impact of expert breast pathology on risk assessment and treatment was determined. RESULTS: 481 individuals with DCIS were referred and pathology review was performed on 350 patients (73%). Inter-observer agreement was high for the main pathologic features of DCIS. From 1996 to 2000, secondary pathology assessments lead to a change in the assessment of local recurrence risk in 100 cases (29%) and contributed to a change in treatment recommendation in 93 (43%) cases. CONCLUSION: Expert breast pathology assessments continue to be necessary in the management of DCIS.
Authors: Joann G Elmore; Gary M Longton; Patricia A Carney; Berta M Geller; Tracy Onega; Anna N A Tosteson; Heidi D Nelson; Margaret S Pepe; Kimberly H Allison; Stuart J Schnitt; Frances P O'Malley; Donald L Weaver Journal: JAMA Date: 2015-03-17 Impact factor: 56.272
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Authors: Jonathan Klein; Iwa Kong; Lawrence Paszat; Sharon Nofech-Mozes; Wedad Hanna; Deva Thiruchelvam; Steven A Narod; Refik Saskin; Susan J Done; Naomi Miller; Bruce Youngson; Alan Tuck; Sandip Sengupta; Leela Elavathil; Prashant A Jani; Elzbieta Slodkowska; Michel Bonin; Eileen Rakovitch Journal: Springerplus Date: 2015-07-10
Authors: Eileen Rakovitch; Sharon Nofech-Mozes; Wedad Hanna; Frederick L Baehner; Refik Saskin; Steven M Butler; Alan Tuck; Sandip Sengupta; Leela Elavathil; Prashant A Jani; Michel Bonin; Martin C Chang; Susan J Robertson; Elzbieta Slodkowska; Cindy Fong; Joseph M Anderson; Farid Jamshidian; Dave P Miller; Diana B Cherbavaz; Steven Shak; Lawrence Paszat Journal: Breast Cancer Res Treat Date: 2015-06-29 Impact factor: 4.872
Authors: Shi Li; Tianjie Pu; Lin Xiao; Hongwei Gao; Li Li; Feng Ye; Yueping Liu; Hong Bu Journal: J Breast Cancer Date: 2019-01-02 Impact factor: 3.588
Authors: Kimberly A Bertrand; Traci N Bethea; Lynn Rosenberg; Elisa V Bandera; Thaer Khoury; Melissa A Troester; Christine B Ambrosone; Julie R Palmer Journal: Breast Date: 2019-11-06 Impact factor: 4.380