Divergences in diagnosing nodular breast lesions of noncarcinomatous nature
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Nodular breast lesions of noncarcinomatous origin are often of fibroepithelial origin. They may cause classification problems when they are hypocellular or hypercellular; the latter setting may also raise the differential diagnosis of phyllodes tumors. Thirty equivocal nodular breast lesions were collected and one hematoxylin and eosin slide from each was assessed by six pathologists with special interest in breast pathology. The overall reproducibility of classifying these lesions into categories of fibroadenoma, phyllodes tumor or anything else was moderate (kappa value: 0.48). The lack of a uniform nomenclature was not felt disturbing for hypocellular lesions, but the discordant diagnosis of tumors resembling or representing phyllodes tumors was acknowledged to require intervention, such as more obvious implication of guidelines and quality assurance programs aiming at assessing diagnoses and prognostic parameters.
Key wordsfibroepithelial breast tumors nodular lesions phyllodes tumor phylloid tumor fibroadenoma
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- 1.Azzopardi J: Problems in breast pathology. Saunders, London-Philadelphia-Toronto, 1979Google Scholar
- 2.Bellocq JP, Magro G: Fibroepithelial tumors. In: WHO Classification of Tumors. Pathology and Genetics of Tumors of the Breast and Female Genital Organs. (Eds: Tavassoli FA, Devilee P), IARC Press, Lyon, 2003, pp 99–103Google Scholar
- 7.Ellis IO, Pinder SE, Bobrow L, et al: Pathology reporting of breast disease. NHS Publication No 58. NHS Cancer Screening Programmes and the Royal College of Pathologists, Sheffield, 2005Google Scholar
- 10.Fleiss JL: The measurement of interrater agreement. In: Statistical Methods for Rates and Proportions. (Ed: Fleiss JL), 2nd ed., John Wiley and Sons, New York, 1981, pp 212–236Google Scholar
- 14.National Mammographic Screening Working Party: Guidelines for the diagnosis and treatment of early breast cancer and mammographic breast screening. Országos Tisztifoorvosi Hivatal, Budapest, 2005 [In Hungarian]Google Scholar
- 15.Perry N, Broeders M, et al (eds): European guidelines for breast screening and diagnosis. European Communities, Luxemburg, 2006Google Scholar
- 18.Rosen PP: Rosen’s Breast Pathology, 2nd edition. Lippincott, Williams and Wilkins, Philadelphia, 2001Google Scholar
- 19.Rosen PP, Oberman HA: Tumors of the Mammary Gland. Atlas of Tumor Pathology, 3rd series. Armed Forces Institute of Pathology, Washington DC, 1993Google Scholar
- 20.Tavassoli FA: Pathology of the Breast, 2nd edition. McGraw-Hill, New York, 1999Google Scholar
- 21.Trojani M: Atlas en couleur d’histopathologie mammaire. Maloine, Paris, 1988Google Scholar