Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities
<p>Abstract</p> <p>Background</p> <p>As high percentage of mammographic densities complicates the assessment of imaging findings, mammographic density may influence the histopathological evaluation of core-biopsies of the breast. We measured the influence of mammographi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-11-01
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| Series: | BMC Cancer |
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| Online Access: | http://www.biomedcentral.com/1471-2407/12/554 |
| _version_ | 1818234497007616000 |
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| author | Trocchi Pietro Ursin Giske Kuss Oliver Ruschke Kathrin Schmidt-Pokrzywniak Andrea Holzhausen Hans-Jürgen Löning Thomas Thomssen Christoph Böcker Werner Kluttig Alexander Stang Andreas |
| author_facet | Trocchi Pietro Ursin Giske Kuss Oliver Ruschke Kathrin Schmidt-Pokrzywniak Andrea Holzhausen Hans-Jürgen Löning Thomas Thomssen Christoph Böcker Werner Kluttig Alexander Stang Andreas |
| author_sort | Trocchi Pietro |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>As high percentage of mammographic densities complicates the assessment of imaging findings, mammographic density may influence the histopathological evaluation of core-biopsies of the breast. We measured the influence of mammographic density on the inter-observer variability of histopathological findings of breast biopsies.</p> <p>Methods</p> <p>Histological slides of 695 women who underwent core biopsies of the breast at University of Halle between 2006 and 2008 were evaluated in a blinded fashion by two pathologists using the five levels of the B-categorization scheme (B1-B5). To quantify mammographic density, we used a computer-based threshold method (Madena). We calculated observed and chance-corrected agreements (weighted kappa) and 95% confidence intervals (95% CI) according to four categories of mammographic density (<10%, 10<25%, 25<50%, ≥50%).</p> <p>Results</p> <p>The weighted kappa decreased monotonically from 89.6% (95% CI: 85.8%, 93.3%) among women with less than 10% of mammographic density to 80.4% (95% CI: 69.9%, 90.9%) for women with more than 50% of mammographic density, respectively. Results of a kappa regression analysis showed that agreement of pathologists on clinically relevant categories (B1-B2 versus B3-B5) decreased with mammographic density.</p> <p>Conclusions</p> <p>Mammographic density is a relevant modifier of the agreement between pathologists who assess breast biopsies using the B-categorization scheme. The influence of mammographic density on the inter-observer variability can be explained to some extent by varying prevalences of histological entities across B categories that have typically different inter-observer agreement. Women with high mammographic density are at higher risk of inter-observer variability compared to women with low mammographic density and should possibly undergo a second pathology review.</p> |
| first_indexed | 2024-12-12T11:39:00Z |
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| id | doaj.art-48e9137046464924b9634f819cd265d3 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-12T11:39:00Z |
| publishDate | 2012-11-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj.art-48e9137046464924b9634f819cd265d32022-12-22T00:25:35ZengBMCBMC Cancer1471-24072012-11-0112155410.1186/1471-2407-12-554Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalitiesTrocchi PietroUrsin GiskeKuss OliverRuschke KathrinSchmidt-Pokrzywniak AndreaHolzhausen Hans-JürgenLöning ThomasThomssen ChristophBöcker WernerKluttig AlexanderStang Andreas<p>Abstract</p> <p>Background</p> <p>As high percentage of mammographic densities complicates the assessment of imaging findings, mammographic density may influence the histopathological evaluation of core-biopsies of the breast. We measured the influence of mammographic density on the inter-observer variability of histopathological findings of breast biopsies.</p> <p>Methods</p> <p>Histological slides of 695 women who underwent core biopsies of the breast at University of Halle between 2006 and 2008 were evaluated in a blinded fashion by two pathologists using the five levels of the B-categorization scheme (B1-B5). To quantify mammographic density, we used a computer-based threshold method (Madena). We calculated observed and chance-corrected agreements (weighted kappa) and 95% confidence intervals (95% CI) according to four categories of mammographic density (<10%, 10<25%, 25<50%, ≥50%).</p> <p>Results</p> <p>The weighted kappa decreased monotonically from 89.6% (95% CI: 85.8%, 93.3%) among women with less than 10% of mammographic density to 80.4% (95% CI: 69.9%, 90.9%) for women with more than 50% of mammographic density, respectively. Results of a kappa regression analysis showed that agreement of pathologists on clinically relevant categories (B1-B2 versus B3-B5) decreased with mammographic density.</p> <p>Conclusions</p> <p>Mammographic density is a relevant modifier of the agreement between pathologists who assess breast biopsies using the B-categorization scheme. The influence of mammographic density on the inter-observer variability can be explained to some extent by varying prevalences of histological entities across B categories that have typically different inter-observer agreement. Women with high mammographic density are at higher risk of inter-observer variability compared to women with low mammographic density and should possibly undergo a second pathology review.</p>http://www.biomedcentral.com/1471-2407/12/554BiopsyBreast diseasesMammographic densityObserver variation |
| spellingShingle | Trocchi Pietro Ursin Giske Kuss Oliver Ruschke Kathrin Schmidt-Pokrzywniak Andrea Holzhausen Hans-Jürgen Löning Thomas Thomssen Christoph Böcker Werner Kluttig Alexander Stang Andreas Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities BMC Cancer Biopsy Breast diseases Mammographic density Observer variation |
| title | Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| title_full | Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| title_fullStr | Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| title_full_unstemmed | Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| title_short | Mammographic density and inter-observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| title_sort | mammographic density and inter observer variability of pathologic evaluation of core biopsies among women with mammographic abnormalities |
| topic | Biopsy Breast diseases Mammographic density Observer variation |
| url | http://www.biomedcentral.com/1471-2407/12/554 |
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