학술논문
Identification of Glandular (Acinar)/Tubule Formation in Invasive Carcinoma of the Breast: A Study to Determine Concordance Using the World Health Organization Definition.
Document Type
Academic Journal
Author
Lo Y; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Lester SC; the Department of Pathology, Brigham and Women's Hospital and the Dana-Farber/Harvard Cancer Center, Boston, Massachusetts (Lester, Aldrees, Ngo, Schnitt).; Ellis IO; the Department of Histopathology, University of Nottingham/Nottingham City Hospital, Nottingham, United Kingdom (Ellis).; Lanjewar S; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Laurini J; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Patel A; the Department of Pathology, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York (Patel).; Bhattarai A; the Department of Pathology, Methodist University Hospital, Memphis, Tennessee (Bhattarai, Bradley).; Ustun B; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Harmon B; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Kleer CG; the Department of Pathology, University of Michigan, Ann Arbor (Kleer, Abbott).; Ross D; the Department of Pathology Memorial Sloan Kettering Cancer Center, New York, New York (Ross, D'Alfonso).; Amin A; the Department of Pathology, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Amin, Wang, Singh).; Wang Y; the Department of Pathology, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Amin, Wang, Singh).; Bradley R; the Department of Pathology, Methodist University Hospital, Memphis, Tennessee (Bhattarai, Bradley).; Turashvili G; the Department of Pathology, Emory University Hospital, Atlanta, Georgia (Turashvili, Badve).; Zeng J; the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Zeng, Collins).; Baum J; the Department of Pathology, NYU Langone Hospital, Mineola, New York (Baum, Ginter, Flieder).; Singh K; the Department of Pathology, Warren Alpert Medical School of Brown University, Providence, Rhode Island (Amin, Wang, Singh).; Hakima L; the Department of Pathology, University of North Carolina Hospitals, Chapel Hill (Hakima).; Harigopal M; the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Harigopal).; Komforti M; the Department of Pathology, Mayo Clinic, Jacksonville, Florida (Komforti, Nassar).; Shin SJ; the Department of Pathology, Albany Medical College, Albany, New York (Shin).; Abbott SE; the Department of Pathology, University of Michigan, Ann Arbor (Kleer, Abbott).; Jaffer S; the Department of Pathology, Lenox Hill Hospital/Northwell Health, New York, New York (Jaffer).; Badve SS; the Department of Pathology, Emory University Hospital, Atlanta, Georgia (Turashvili, Badve).; Khoury T; the Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York (Khoury).; D'Alfonso TM; the Department of Pathology Memorial Sloan Kettering Cancer Center, New York, New York (Ross, D'Alfonso).; Ginter PS; the Department of Pathology, NYU Langone Hospital, Mineola, New York (Baum, Ginter, Flieder).; Collins V; the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Zeng, Collins).; Towne W; the Department of Pathology, Columbia University/New York Presbyterian Hospital, New York, New York (Towne).; Gan Y; the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Gan).; Nassar A; the Department of Pathology, Mayo Clinic, Jacksonville, Florida (Komforti, Nassar).; Sahin AA; the Department of Pathology, MD Anderson Cancer Center, Houston, Texas (Sahin).; Flieder A; the Department of Pathology, NYU Langone Hospital, Mineola, New York (Baum, Ginter, Flieder).; Aldrees R; the Department of Pathology, Brigham and Women's Hospital and the Dana-Farber/Harvard Cancer Center, Boston, Massachusetts (Lester, Aldrees, Ngo, Schnitt).; Ngo MH; the Department of Pathology, Brigham and Women's Hospital and the Dana-Farber/Harvard Cancer Center, Boston, Massachusetts (Lester, Aldrees, Ngo, Schnitt).; Edema U; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Sapna F; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.; Schnitt SJ; the Department of Pathology, Brigham and Women's Hospital and the Dana-Farber/Harvard Cancer Center, Boston, Massachusetts (Lester, Aldrees, Ngo, Schnitt).; Fineberg SA; From the Departments of Epidemiology and Population Health (Lo) and Pathology (Fineberg, Lanjewar, Laurini, Ustun, Harmon, Edema, Sapna), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Source
Publisher: College of American Pathologists Country of Publication: United States NLM ID: 7607091 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1543-2165 (Electronic) Linking ISSN: 00039985 NLM ISO Abbreviation: Arch Pathol Lab Med Subsets: MEDLINE
Subject
Language
English
Abstract
Context.—: The Nottingham Grading System (NGS) developed by Elston and Ellis is used to grade invasive breast cancer (IBC). Glandular (acinar)/tubule formation is a component of NGS.
Objective.—: To investigate the ability of pathologists to identify individual structures that should be classified as glandular (acinar)/tubule formation.
Design.—: A total of 58 hematoxylin-eosin photographic images of IBC with 1 structure circled were classified as tubules (41 cases) or nontubules (17 cases) by Professor Ellis. Images were sent as a PowerPoint (Microsoft) file to breast pathologists, who were provided with the World Health Organization definition of a tubule and asked to determine if a circled structure represented a tubule.
Results.—: Among 35 pathologists, the κ statistic for assessing agreement in evaluating the 58 images was 0.324 (95% CI, 0.314-0.335). The median concordance rate between a participating pathologist and Professor Ellis was 94.1% for evaluating 17 nontubule cases and 53.7% for 41 tubule cases. A total of 41% of the tubule cases were classified correctly by less than 50% of pathologists. Structures classified as tubules by Professor Ellis but often not recognized as tubules by pathologists included glands with complex architecture, mucinous carcinoma, and the "inverted tubule" pattern of micropapillary carcinoma. A total of 80% of participants reported that they did not have clarity on what represented a tubule.
Conclusions.—: We identified structures that should be included as tubules but that were not readily identified by pathologists. Greater concordance for identification of tubules might be obtained by providing more detailed images and descriptions of the types of structures included as tubules.
(© 2024 College of American Pathologists.)
Objective.—: To investigate the ability of pathologists to identify individual structures that should be classified as glandular (acinar)/tubule formation.
Design.—: A total of 58 hematoxylin-eosin photographic images of IBC with 1 structure circled were classified as tubules (41 cases) or nontubules (17 cases) by Professor Ellis. Images were sent as a PowerPoint (Microsoft) file to breast pathologists, who were provided with the World Health Organization definition of a tubule and asked to determine if a circled structure represented a tubule.
Results.—: Among 35 pathologists, the κ statistic for assessing agreement in evaluating the 58 images was 0.324 (95% CI, 0.314-0.335). The median concordance rate between a participating pathologist and Professor Ellis was 94.1% for evaluating 17 nontubule cases and 53.7% for 41 tubule cases. A total of 41% of the tubule cases were classified correctly by less than 50% of pathologists. Structures classified as tubules by Professor Ellis but often not recognized as tubules by pathologists included glands with complex architecture, mucinous carcinoma, and the "inverted tubule" pattern of micropapillary carcinoma. A total of 80% of participants reported that they did not have clarity on what represented a tubule.
Conclusions.—: We identified structures that should be included as tubules but that were not readily identified by pathologists. Greater concordance for identification of tubules might be obtained by providing more detailed images and descriptions of the types of structures included as tubules.
(© 2024 College of American Pathologists.)