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Divergences in diagnosing nodular breast lesions of noncarcinomatous nature

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Pathology & Oncology Research

Abstract

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.

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References

  1. Azzopardi J: Problems in breast pathology. Saunders, London-Philadelphia-Toronto, 1979

    Google 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 99–103

    Google Scholar 

  3. Berean K, Iron VA, Churg A, et al: Mammary fibroadenoma with multinucleated stromal giant cells. Am J Surg Pathol 10: 823–827, 1986

    Article  PubMed  CAS  Google Scholar 

  4. Chen WH, Cheng SP, Tzen CY, et al: Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol 91: 185–194, 2005

    Article  PubMed  Google Scholar 

  5. Cserni G: Adaptation of mitotic scoring of breast carcinomas. Hum Pathol 27:617–618, 1996

    Article  PubMed  CAS  Google Scholar 

  6. Daya D, Trus T, D’Souza TJ, et al: Hamartoma of the breast, an under-recognized breast lesion. A clinicopathologic and radiographic study of 25 cases. Am J Clin Pathol 103: 685–689, 1995

    PubMed  CAS  Google 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, 2005

    Google Scholar 

  8. Elston CW, Ellis IO: Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: Experience from a larger study with long term follow up. Histopathology 19:403–410, 1991

    Article  PubMed  CAS  Google Scholar 

  9. Fisher CJ, Hanby AM, Robinson L, et al: Mammary hamartoma — a review of 35 cases. Histopathology 20: 99–106, 1992

    Article  PubMed  CAS  Google 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 212–236

    Google Scholar 

  11. Kuijper A, Buerger H, Simon R, et al: Analysis of the progression of fibroepithelial tumors of the breast by PCR-based clonality assay. J Pathol 197: 575–581, 2002

    Article  PubMed  Google Scholar 

  12. Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 33: 159–174, 1977

    Article  PubMed  CAS  Google Scholar 

  13. Moffat CJ, Pinder SE, Dixon AR, et al: Phyllodes tumors of the breast: a clinicopathological review of thirty-two cases. Histopathology 27: 205–218, 1995.

    Article  PubMed  CAS  Google 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, 2006

    Google Scholar 

  16. Putti TC, Pinder SE, Elston CW, et al: Breast pathology practice: most common problems in a consultation service. Histopathology 47: 445–457, 2005

    Article  PubMed  CAS  Google Scholar 

  17. Rajan PB, Cranor ML, Rosen PP: Cystosarcoma phyllodes in adolescent girls and young women: a study of 45 patients. Am J Surg Pathol 22: 64–69, 1998

    Article  PubMed  CAS  Google Scholar 

  18. Rosen PP: Rosen’s Breast Pathology, 2nd edition. Lippincott, Williams and Wilkins, Philadelphia, 2001

    Google Scholar 

  19. Rosen PP, Oberman HA: Tumors of the Mammary Gland. Atlas of Tumor Pathology, 3rd series. Armed Forces Institute of Pathology, Washington DC, 1993

    Google Scholar 

  20. Tavassoli FA: Pathology of the Breast, 2nd edition. McGraw-Hill, New York, 1999

    Google Scholar 

  21. Trojani M: Atlas en couleur d’histopathologie mammaire. Maloine, Paris, 1988

    Google Scholar 

  22. Tse GM, Law BK, Ma TK, et al: Hamartoma of the breast: a clinico-pathological review. J Clin Pathol 55: 951–954, 2002

    Article  PubMed  CAS  Google Scholar 

  23. Vuitch MF, Rosen PP, Erlandson RA: Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol 17: 185–191, 1986

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Gábor Cserni.

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Cserni, G., Orosz, Z., Kulka, J. et al. Divergences in diagnosing nodular breast lesions of noncarcinomatous nature. Pathol. Oncol. Res. 12, 216–221 (2006). https://doi.org/10.1007/BF02893415

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  • DOI: https://doi.org/10.1007/BF02893415

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