Professor EMAD RAKHA Emad.Rakha@nottingham.ac.uk
PROFESSOR OF BREAST CANCER PATHOLOGY
Diagnostic concordance of reporting lymphovascular invasion in breast cancer
Rakha, Emad A.; Abbas, Areeg; Pinto Ahumada, Pablo; ElSayed, Maysa E.; Colman, Derek; Pinder, Sarah E.; Ellis, Ian O.
Authors
Areeg Abbas
Pablo Pinto Ahumada
Maysa E. ElSayed
Derek Colman
Sarah E. Pinder
Ian O. Ellis
Abstract
Aims: This study aims to assess the diagnostic agreement of lymphovascular invasion (LVI) in invasive breast cancer (BC).
Methods: Data on LVI were collected from the UK National Health Service Breast Screening Programme pathology external quality assurance scheme database. 101 BCs assessed over a 10-year period (2004–2014) were included. Cases were scored by an average of 600 pathologists. Three H&E stained slides from each case were reviewed by three pathologists and additional variables were evaluated.
Results: In the whole series, the overall κ value was 0.4 (range 0.26–0.53). On review, LVI was detected in all three slides in 20 cases (20%), in two slides in 12 cases and in one of the three slides in 9 cases and was not seen in 60 cases. For concordance analysis, the first and last groups were used to represent cases with definite (LVI+) and absent LVI (LVI–), respectively. In the LVI+group (n=20), the level of agreement ranged from 0.54 to 0.99 (median 0.86). In the LVI– group (n=60), the level of agreement ranged from 0.52 to 1.00 (median 0.93), with 44% of cases showing interobserver concordance of >95%. There was a correlation between increasing number of involved lymphovascular spaces in the section and higher LVI reporting concordance. Some degree of retraction/fixation artefacts was observed in 35% of cases; this was associated with a lower concordance rate.
Conclusions: The concordance of reporting LVI is variable. Cases without LVI and those with multiple involved vessels are likely to have the highest concordance and the highest detection rates.
Citation
Rakha, E. A., Abbas, A., Pinto Ahumada, P., ElSayed, M. E., Colman, D., Pinder, S. E., & Ellis, I. O. (2018). Diagnostic concordance of reporting lymphovascular invasion in breast cancer. Journal of Clinical Pathology, 71(9), 802-805. https://doi.org/10.1136/jclinpath-2017-204981
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 17, 2018 |
Online Publication Date | Mar 29, 2018 |
Publication Date | 2018-09 |
Deposit Date | Oct 24, 2018 |
Journal | Journal of Clinical Pathology |
Print ISSN | 0021-9746 |
Electronic ISSN | 1472-4146 |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 71 |
Issue | 9 |
Pages | 802-805 |
DOI | https://doi.org/10.1136/jclinpath-2017-204981 |
Keywords | Pathology and Forensic Medicine; General Medicine |
Public URL | https://nottingham-repository.worktribe.com/output/1184832 |
Publisher URL | https://jcp.bmj.com/content/71/9/802 |
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