BACKGROUND: The assessment of the proliferation fraction is becoming more and more important; however, there is no consensus concerning optimal validation. Depending on the institute the proliferation fraction is determined either from a core biopsy (SB) or resection specimen (OP). PATIENTS AND METHODS: The interobserver variability and the results of SB and OP were investigated whereby two pathologists independently estimated the proliferation fraction of 90 cases of invasive breast cancer. The results (Ki-67) were quantified, categorized, and compared. RESULTS: Identical (accuracy of 5% steps) results between the 2 pathologists were achieved in 43% (n=39) for SB, 47% (n=42) for OP and 60% (n=54) for SB versus OP. When categorizing the proliferation fraction (low ≤ 15%, moderate 20-30% and high ≥ 35%) the following results were achieved: 76% (n=68) for SB, 82% (n=74) for OP and 81% (n=73) for SB versus OP. CONCLUSIONS: There was a clear interobserver variability (SB: kappa=0.32, OP: kappa=0.34) but this could be dramatically improved by forming proliferation categories (SB: kappa=0.62, OP: kappa=0.72, 60 versus 81%). In SB with a low proliferation fraction a repeated analysis in OPs can be advisable as a higher proliferation fraction is observed in up to 12% of OPs.
BACKGROUND: The assessment of the proliferation fraction is becoming more and more important; however, there is no consensus concerning optimal validation. Depending on the institute the proliferation fraction is determined either from a core biopsy (SB) or resection specimen (OP). PATIENTS AND METHODS: The interobserver variability and the results of SB and OP were investigated whereby two pathologists independently estimated the proliferation fraction of 90 cases of invasive breast cancer. The results (Ki-67) were quantified, categorized, and compared. RESULTS: Identical (accuracy of 5% steps) results between the 2 pathologists were achieved in 43% (n=39) for SB, 47% (n=42) for OP and 60% (n=54) for SB versus OP. When categorizing the proliferation fraction (low ≤ 15%, moderate 20-30% and high ≥ 35%) the following results were achieved: 76% (n=68) for SB, 82% (n=74) for OP and 81% (n=73) for SB versus OP. CONCLUSIONS: There was a clear interobserver variability (SB: kappa=0.32, OP: kappa=0.34) but this could be dramatically improved by forming proliferation categories (SB: kappa=0.62, OP: kappa=0.72, 60 versus 81%). In SB with a low proliferation fraction a repeated analysis in OPs can be advisable as a higher proliferation fraction is observed in up to 12% of OPs.
Authors: Michael Mengel; Reinhard von Wasielewski; Birgitt Wiese; Thomas Rüdiger; Hans Konrad Müller-Hermelink; Hans Kreipe Journal: J Pathol Date: 2002-11 Impact factor: 7.996
Authors: A Neri; D Marrelli; C Pedrazzani; S Caruso; A De Stefano; F Mariani; T Megha; G De Marco; G Corso; E Pinto; F Roviello Journal: Eur J Surg Oncol Date: 2008-03-04 Impact factor: 4.424
Authors: Mitch Dowsett; Torsten O Nielsen; Roger A'Hern; John Bartlett; R Charles Coombes; Jack Cuzick; Matthew Ellis; N Lynn Henry; Judith C Hugh; Tracy Lively; Lisa McShane; Soon Paik; Frederique Penault-Llorca; Ljudmila Prudkin; Meredith Regan; Janine Salter; Christos Sotiriou; Ian E Smith; Giuseppe Viale; Jo Anne Zujewski; Daniel F Hayes Journal: J Natl Cancer Inst Date: 2011-09-29 Impact factor: 13.506
Authors: A Bottini; A Berruti; A Bersiga; M P Brizzi; P Bruzzi; S Aguggini; A Brunelli; G Bolsi; G Allevi; D Generali; E Betri; G Bertoli; P Alquati; L Dogliotti Journal: Br J Cancer Date: 2001-10-19 Impact factor: 7.640
Authors: E de Azambuja; F Cardoso; G de Castro; M Colozza; M S Mano; V Durbecq; C Sotiriou; D Larsimont; M J Piccart-Gebhart; M Paesmans Journal: Br J Cancer Date: 2007-04-24 Impact factor: 7.640