Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study
Purpose For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsi...
Gespeichert in:
| Veröffentlicht in: | Breast cancer research and treatment 2020-10, Vol.183 (3), p.759-770 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 770 |
|---|---|
| container_issue | 3 |
| container_start_page | 759 |
| container_title | Breast cancer research and treatment |
| container_volume | 183 |
| creator | Groen, Emma J. Hudecek, Jan Mulder, Lennart van Seijen, Maartje Almekinders, Mathilde M. Alexov, Stoyan Kovács, Anikó Ryska, Ales Varga, Zsuzsanna Andreu Navarro, Francisco-Javier Bianchi, Simonetta Vreuls, Willem Balslev, Eva Boot, Max V. Kulka, Janina Chmielik, Ewa Barbé, Ellis de Rooij, Mathilda J. Vos, Winand Farkas, Andrea Leeuwis-Fedorovich, Natalja E. Regitnig, Peter Westenend, Pieter J. Kooreman, Loes F. S. Quinn, Cecily Floris, Giuseppe Cserni, Gábor van Diest, Paul J. Lips, Esther H. Schaapveld, Michael Wesseling, Jelle |
| description | Purpose
For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsilateral invasive breast cancer (iIBC) risk.
Methods
Using a case-cohort design, reliability was assessed in a population-based, nationwide cohort of 2767 women with screen-detected DCIS diagnosed between 1993 and 2004, treated by breast-conserving surgery with/without radiotherapy (BCS ± RT) using Krippendorff’s alpha (KA) and Gwet’s AC2 (GAC2). Thirty-eight raters scored histopathological DCIS features including grade (2-tiered and 3-tiered), growth pattern, mitotic activity, periductal fibrosis, and lymphocytic infiltrate in 342 women. Using majority opinion-based scores for each feature, their association with subsequent iIBC risk was assessed using Cox regression.
Results
Interrater reliability of grade using various classifications was fair to moderate, and only substantial for grade 1 versus 2 + 3 when using GAC2 (0.78). Reliability for growth pattern (KA 0.44, GAC2 0.78), calcifications (KA 0.49, GAC2 0.70) and necrosis (KA 0.47, GAC2 0.70) was moderate using KA and substantial using GAC2; for (type of) periductal fibrosis and lymphocytic infiltrate fair to moderate estimates were found and for mitotic activity reliability was substantial using GAC2 (0.70). Only in patients treated with BCS-RT, high mitotic activity was associated with a higher iIBC risk in univariable analysis (Hazard Ratio (HR) 2.53, 95% Confidence Interval (95% CI) 1.05–6.11); grade 3 versus 1 + 2 (HR 2.64, 95% CI 1.35–5.14) and a cribriform/solid versus flat epithelial atypia/clinging/(micro)papillary growth pattern (HR 3.70, 95% CI 1.34–10.23) were independently associated with a higher iIBC risk.
Conclusions
Using majority opinion-based scores, DCIS grade, growth pattern, and mitotic activity are associated with iIBC risk in patients treated with BCS-RT, but interrater variability is substantial. Semi-quantitative grading, incorporating and separately evaluating nuclear pleomorphism, growth pattern, and mitotic activity, may improve the reliability and prognostic value of these features. |
| doi_str_mv | 10.1007/s10549-020-05816-x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7497690</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A635722895</galeid><sourcerecordid>A635722895</sourcerecordid><originalsourceid>FETCH-LOGICAL-c638t-9dda07c161abdf4f0857b8a76997c19a7874ab1af9d38817c657f90fe85586d63</originalsourceid><addsrcrecordid>eNp9kl1rFDEUhgdR7Fr9A17IgCDeTE0yk5zkRijrV6GgoF6HszPJbEp2siaZ0v33Zru1HyISSMg5z3kPOXmr6iUlJ5QQeJco4Z1qCCMN4ZKK5upRtaAc2gYYhcfVglABjZBEHFXPUroghCgg6ml11DJoO87IogrfYhinkLLr60v0s6mDrdcu5bDFvA4-jK5HX39Ynn2vrcE8R5NqN9VYe4yjaVLJmhLIJk6YXZgKfH2LWLY6Gu9w5bzLuzrledg9r55Y9Mm8uDmPq5-fPv5YfmnOv34-W56eN71oZW7UMCCBngqKq8F2lkgOK4kglCpRhSChwxVFq4ZWSgq94GAVsUZyLsUg2uPq_UF3O682ZujNlCN6vY1ug3GnAzr9MDO5tR7DpYZOlS6kCLy9EYjh12xS1huXeuM9TibMSbOOKQAOwAr6-i_0IsxlHH5PdUy2LRBxR41lYtpNNpS-_V5Un4qWA2NS8UKd_IMqazAb14fJWFfiDwre3CtYG_R5nYKf93-RHoLsAPYxpBSNvR0GJXrvJ33wky5-0td-0lel6NX9Md6W_DFQAdoDkEpqGk28e_t_ZH8DqXjW2Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2442833706</pqid></control><display><type>article</type><title>Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Groen, Emma J. ; Hudecek, Jan ; Mulder, Lennart ; van Seijen, Maartje ; Almekinders, Mathilde M. ; Alexov, Stoyan ; Kovács, Anikó ; Ryska, Ales ; Varga, Zsuzsanna ; Andreu Navarro, Francisco-Javier ; Bianchi, Simonetta ; Vreuls, Willem ; Balslev, Eva ; Boot, Max V. ; Kulka, Janina ; Chmielik, Ewa ; Barbé, Ellis ; de Rooij, Mathilda J. ; Vos, Winand ; Farkas, Andrea ; Leeuwis-Fedorovich, Natalja E. ; Regitnig, Peter ; Westenend, Pieter J. ; Kooreman, Loes F. S. ; Quinn, Cecily ; Floris, Giuseppe ; Cserni, Gábor ; van Diest, Paul J. ; Lips, Esther H. ; Schaapveld, Michael ; Wesseling, Jelle</creator><creatorcontrib>Groen, Emma J. ; Hudecek, Jan ; Mulder, Lennart ; van Seijen, Maartje ; Almekinders, Mathilde M. ; Alexov, Stoyan ; Kovács, Anikó ; Ryska, Ales ; Varga, Zsuzsanna ; Andreu Navarro, Francisco-Javier ; Bianchi, Simonetta ; Vreuls, Willem ; Balslev, Eva ; Boot, Max V. ; Kulka, Janina ; Chmielik, Ewa ; Barbé, Ellis ; de Rooij, Mathilda J. ; Vos, Winand ; Farkas, Andrea ; Leeuwis-Fedorovich, Natalja E. ; Regitnig, Peter ; Westenend, Pieter J. ; Kooreman, Loes F. S. ; Quinn, Cecily ; Floris, Giuseppe ; Cserni, Gábor ; van Diest, Paul J. ; Lips, Esther H. ; Schaapveld, Michael ; Wesseling, Jelle ; Grand Challenge PRECISION consortium ; Grand Challenge PRECISION consortium</creatorcontrib><description>Purpose
For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsilateral invasive breast cancer (iIBC) risk.
Methods
Using a case-cohort design, reliability was assessed in a population-based, nationwide cohort of 2767 women with screen-detected DCIS diagnosed between 1993 and 2004, treated by breast-conserving surgery with/without radiotherapy (BCS ± RT) using Krippendorff’s alpha (KA) and Gwet’s AC2 (GAC2). Thirty-eight raters scored histopathological DCIS features including grade (2-tiered and 3-tiered), growth pattern, mitotic activity, periductal fibrosis, and lymphocytic infiltrate in 342 women. Using majority opinion-based scores for each feature, their association with subsequent iIBC risk was assessed using Cox regression.
Results
Interrater reliability of grade using various classifications was fair to moderate, and only substantial for grade 1 versus 2 + 3 when using GAC2 (0.78). Reliability for growth pattern (KA 0.44, GAC2 0.78), calcifications (KA 0.49, GAC2 0.70) and necrosis (KA 0.47, GAC2 0.70) was moderate using KA and substantial using GAC2; for (type of) periductal fibrosis and lymphocytic infiltrate fair to moderate estimates were found and for mitotic activity reliability was substantial using GAC2 (0.70). Only in patients treated with BCS-RT, high mitotic activity was associated with a higher iIBC risk in univariable analysis (Hazard Ratio (HR) 2.53, 95% Confidence Interval (95% CI) 1.05–6.11); grade 3 versus 1 + 2 (HR 2.64, 95% CI 1.35–5.14) and a cribriform/solid versus flat epithelial atypia/clinging/(micro)papillary growth pattern (HR 3.70, 95% CI 1.34–10.23) were independently associated with a higher iIBC risk.
Conclusions
Using majority opinion-based scores, DCIS grade, growth pattern, and mitotic activity are associated with iIBC risk in patients treated with BCS-RT, but interrater variability is substantial. Semi-quantitative grading, incorporating and separately evaluating nuclear pleomorphism, growth pattern, and mitotic activity, may improve the reliability and prognostic value of these features.</description><identifier>ISSN: 0167-6806</identifier><identifier>ISSN: 1573-7217</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-020-05816-x</identifier><identifier>PMID: 32734520</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Breast cancer ; Breast Neoplasms - surgery ; Cancer research ; Carcinoma, Ductal ; Carcinoma, Ductal, Breast - surgery ; Carcinoma, Intraductal, Noninfiltrating - surgery ; Confidence intervals ; Epidemiology ; Female ; Fibrosis ; Football (College) ; Growth patterns ; Health aspects ; Humans ; Invasiveness ; Lumpectomy ; Mastectomy, Segmental ; Medical research ; Medical screening ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local ; Oncology ; Patients ; Pleomorphism ; Prognosis ; Radiation therapy ; Reproducibility of Results ; Surgery</subject><ispartof>Breast cancer research and treatment, 2020-10, Vol.183 (3), p.759-770</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c638t-9dda07c161abdf4f0857b8a76997c19a7874ab1af9d38817c657f90fe85586d63</citedby><cites>FETCH-LOGICAL-c638t-9dda07c161abdf4f0857b8a76997c19a7874ab1af9d38817c657f90fe85586d63</cites><orcidid>0000-0002-8940-2676</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-020-05816-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-020-05816-x$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32734520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Groen, Emma J.</creatorcontrib><creatorcontrib>Hudecek, Jan</creatorcontrib><creatorcontrib>Mulder, Lennart</creatorcontrib><creatorcontrib>van Seijen, Maartje</creatorcontrib><creatorcontrib>Almekinders, Mathilde M.</creatorcontrib><creatorcontrib>Alexov, Stoyan</creatorcontrib><creatorcontrib>Kovács, Anikó</creatorcontrib><creatorcontrib>Ryska, Ales</creatorcontrib><creatorcontrib>Varga, Zsuzsanna</creatorcontrib><creatorcontrib>Andreu Navarro, Francisco-Javier</creatorcontrib><creatorcontrib>Bianchi, Simonetta</creatorcontrib><creatorcontrib>Vreuls, Willem</creatorcontrib><creatorcontrib>Balslev, Eva</creatorcontrib><creatorcontrib>Boot, Max V.</creatorcontrib><creatorcontrib>Kulka, Janina</creatorcontrib><creatorcontrib>Chmielik, Ewa</creatorcontrib><creatorcontrib>Barbé, Ellis</creatorcontrib><creatorcontrib>de Rooij, Mathilda J.</creatorcontrib><creatorcontrib>Vos, Winand</creatorcontrib><creatorcontrib>Farkas, Andrea</creatorcontrib><creatorcontrib>Leeuwis-Fedorovich, Natalja E.</creatorcontrib><creatorcontrib>Regitnig, Peter</creatorcontrib><creatorcontrib>Westenend, Pieter J.</creatorcontrib><creatorcontrib>Kooreman, Loes F. S.</creatorcontrib><creatorcontrib>Quinn, Cecily</creatorcontrib><creatorcontrib>Floris, Giuseppe</creatorcontrib><creatorcontrib>Cserni, Gábor</creatorcontrib><creatorcontrib>van Diest, Paul J.</creatorcontrib><creatorcontrib>Lips, Esther H.</creatorcontrib><creatorcontrib>Schaapveld, Michael</creatorcontrib><creatorcontrib>Wesseling, Jelle</creatorcontrib><creatorcontrib>Grand Challenge PRECISION consortium</creatorcontrib><creatorcontrib>Grand Challenge PRECISION consortium</creatorcontrib><title>Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsilateral invasive breast cancer (iIBC) risk.
Methods
Using a case-cohort design, reliability was assessed in a population-based, nationwide cohort of 2767 women with screen-detected DCIS diagnosed between 1993 and 2004, treated by breast-conserving surgery with/without radiotherapy (BCS ± RT) using Krippendorff’s alpha (KA) and Gwet’s AC2 (GAC2). Thirty-eight raters scored histopathological DCIS features including grade (2-tiered and 3-tiered), growth pattern, mitotic activity, periductal fibrosis, and lymphocytic infiltrate in 342 women. Using majority opinion-based scores for each feature, their association with subsequent iIBC risk was assessed using Cox regression.
Results
Interrater reliability of grade using various classifications was fair to moderate, and only substantial for grade 1 versus 2 + 3 when using GAC2 (0.78). Reliability for growth pattern (KA 0.44, GAC2 0.78), calcifications (KA 0.49, GAC2 0.70) and necrosis (KA 0.47, GAC2 0.70) was moderate using KA and substantial using GAC2; for (type of) periductal fibrosis and lymphocytic infiltrate fair to moderate estimates were found and for mitotic activity reliability was substantial using GAC2 (0.70). Only in patients treated with BCS-RT, high mitotic activity was associated with a higher iIBC risk in univariable analysis (Hazard Ratio (HR) 2.53, 95% Confidence Interval (95% CI) 1.05–6.11); grade 3 versus 1 + 2 (HR 2.64, 95% CI 1.35–5.14) and a cribriform/solid versus flat epithelial atypia/clinging/(micro)papillary growth pattern (HR 3.70, 95% CI 1.34–10.23) were independently associated with a higher iIBC risk.
Conclusions
Using majority opinion-based scores, DCIS grade, growth pattern, and mitotic activity are associated with iIBC risk in patients treated with BCS-RT, but interrater variability is substantial. Semi-quantitative grading, incorporating and separately evaluating nuclear pleomorphism, growth pattern, and mitotic activity, may improve the reliability and prognostic value of these features.</description><subject>Breast cancer</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer research</subject><subject>Carcinoma, Ductal</subject><subject>Carcinoma, Ductal, Breast - surgery</subject><subject>Carcinoma, Intraductal, Noninfiltrating - surgery</subject><subject>Confidence intervals</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Football (College)</subject><subject>Growth patterns</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Invasiveness</subject><subject>Lumpectomy</subject><subject>Mastectomy, Segmental</subject><subject>Medical research</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local</subject><subject>Oncology</subject><subject>Patients</subject><subject>Pleomorphism</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Reproducibility of Results</subject><subject>Surgery</subject><issn>0167-6806</issn><issn>1573-7217</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl1rFDEUhgdR7Fr9A17IgCDeTE0yk5zkRijrV6GgoF6HszPJbEp2siaZ0v33Zru1HyISSMg5z3kPOXmr6iUlJ5QQeJco4Z1qCCMN4ZKK5upRtaAc2gYYhcfVglABjZBEHFXPUroghCgg6ml11DJoO87IogrfYhinkLLr60v0s6mDrdcu5bDFvA4-jK5HX39Ynn2vrcE8R5NqN9VYe4yjaVLJmhLIJk6YXZgKfH2LWLY6Gu9w5bzLuzrledg9r55Y9Mm8uDmPq5-fPv5YfmnOv34-W56eN71oZW7UMCCBngqKq8F2lkgOK4kglCpRhSChwxVFq4ZWSgq94GAVsUZyLsUg2uPq_UF3O682ZujNlCN6vY1ug3GnAzr9MDO5tR7DpYZOlS6kCLy9EYjh12xS1huXeuM9TibMSbOOKQAOwAr6-i_0IsxlHH5PdUy2LRBxR41lYtpNNpS-_V5Un4qWA2NS8UKd_IMqazAb14fJWFfiDwre3CtYG_R5nYKf93-RHoLsAPYxpBSNvR0GJXrvJ33wky5-0td-0lel6NX9Md6W_DFQAdoDkEpqGk28e_t_ZH8DqXjW2Q</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Groen, Emma J.</creator><creator>Hudecek, Jan</creator><creator>Mulder, Lennart</creator><creator>van Seijen, Maartje</creator><creator>Almekinders, Mathilde M.</creator><creator>Alexov, Stoyan</creator><creator>Kovács, Anikó</creator><creator>Ryska, Ales</creator><creator>Varga, Zsuzsanna</creator><creator>Andreu Navarro, Francisco-Javier</creator><creator>Bianchi, Simonetta</creator><creator>Vreuls, Willem</creator><creator>Balslev, Eva</creator><creator>Boot, Max V.</creator><creator>Kulka, Janina</creator><creator>Chmielik, Ewa</creator><creator>Barbé, Ellis</creator><creator>de Rooij, Mathilda J.</creator><creator>Vos, Winand</creator><creator>Farkas, Andrea</creator><creator>Leeuwis-Fedorovich, Natalja E.</creator><creator>Regitnig, Peter</creator><creator>Westenend, Pieter J.</creator><creator>Kooreman, Loes F. S.</creator><creator>Quinn, Cecily</creator><creator>Floris, Giuseppe</creator><creator>Cserni, Gábor</creator><creator>van Diest, Paul J.</creator><creator>Lips, Esther H.</creator><creator>Schaapveld, Michael</creator><creator>Wesseling, Jelle</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8940-2676</orcidid></search><sort><creationdate>20201001</creationdate><title>Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study</title><author>Groen, Emma J. ; Hudecek, Jan ; Mulder, Lennart ; van Seijen, Maartje ; Almekinders, Mathilde M. ; Alexov, Stoyan ; Kovács, Anikó ; Ryska, Ales ; Varga, Zsuzsanna ; Andreu Navarro, Francisco-Javier ; Bianchi, Simonetta ; Vreuls, Willem ; Balslev, Eva ; Boot, Max V. ; Kulka, Janina ; Chmielik, Ewa ; Barbé, Ellis ; de Rooij, Mathilda J. ; Vos, Winand ; Farkas, Andrea ; Leeuwis-Fedorovich, Natalja E. ; Regitnig, Peter ; Westenend, Pieter J. ; Kooreman, Loes F. S. ; Quinn, Cecily ; Floris, Giuseppe ; Cserni, Gábor ; van Diest, Paul J. ; Lips, Esther H. ; Schaapveld, Michael ; Wesseling, Jelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c638t-9dda07c161abdf4f0857b8a76997c19a7874ab1af9d38817c657f90fe85586d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Breast cancer</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer research</topic><topic>Carcinoma, Ductal</topic><topic>Carcinoma, Ductal, Breast - surgery</topic><topic>Carcinoma, Intraductal, Noninfiltrating - surgery</topic><topic>Confidence intervals</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Football (College)</topic><topic>Growth patterns</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Invasiveness</topic><topic>Lumpectomy</topic><topic>Mastectomy, Segmental</topic><topic>Medical research</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local</topic><topic>Oncology</topic><topic>Patients</topic><topic>Pleomorphism</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Reproducibility of Results</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Groen, Emma J.</creatorcontrib><creatorcontrib>Hudecek, Jan</creatorcontrib><creatorcontrib>Mulder, Lennart</creatorcontrib><creatorcontrib>van Seijen, Maartje</creatorcontrib><creatorcontrib>Almekinders, Mathilde M.</creatorcontrib><creatorcontrib>Alexov, Stoyan</creatorcontrib><creatorcontrib>Kovács, Anikó</creatorcontrib><creatorcontrib>Ryska, Ales</creatorcontrib><creatorcontrib>Varga, Zsuzsanna</creatorcontrib><creatorcontrib>Andreu Navarro, Francisco-Javier</creatorcontrib><creatorcontrib>Bianchi, Simonetta</creatorcontrib><creatorcontrib>Vreuls, Willem</creatorcontrib><creatorcontrib>Balslev, Eva</creatorcontrib><creatorcontrib>Boot, Max V.</creatorcontrib><creatorcontrib>Kulka, Janina</creatorcontrib><creatorcontrib>Chmielik, Ewa</creatorcontrib><creatorcontrib>Barbé, Ellis</creatorcontrib><creatorcontrib>de Rooij, Mathilda J.</creatorcontrib><creatorcontrib>Vos, Winand</creatorcontrib><creatorcontrib>Farkas, Andrea</creatorcontrib><creatorcontrib>Leeuwis-Fedorovich, Natalja E.</creatorcontrib><creatorcontrib>Regitnig, Peter</creatorcontrib><creatorcontrib>Westenend, Pieter J.</creatorcontrib><creatorcontrib>Kooreman, Loes F. S.</creatorcontrib><creatorcontrib>Quinn, Cecily</creatorcontrib><creatorcontrib>Floris, Giuseppe</creatorcontrib><creatorcontrib>Cserni, Gábor</creatorcontrib><creatorcontrib>van Diest, Paul J.</creatorcontrib><creatorcontrib>Lips, Esther H.</creatorcontrib><creatorcontrib>Schaapveld, Michael</creatorcontrib><creatorcontrib>Wesseling, Jelle</creatorcontrib><creatorcontrib>Grand Challenge PRECISION consortium</creatorcontrib><creatorcontrib>Grand Challenge PRECISION consortium</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Groen, Emma J.</au><au>Hudecek, Jan</au><au>Mulder, Lennart</au><au>van Seijen, Maartje</au><au>Almekinders, Mathilde M.</au><au>Alexov, Stoyan</au><au>Kovács, Anikó</au><au>Ryska, Ales</au><au>Varga, Zsuzsanna</au><au>Andreu Navarro, Francisco-Javier</au><au>Bianchi, Simonetta</au><au>Vreuls, Willem</au><au>Balslev, Eva</au><au>Boot, Max V.</au><au>Kulka, Janina</au><au>Chmielik, Ewa</au><au>Barbé, Ellis</au><au>de Rooij, Mathilda J.</au><au>Vos, Winand</au><au>Farkas, Andrea</au><au>Leeuwis-Fedorovich, Natalja E.</au><au>Regitnig, Peter</au><au>Westenend, Pieter J.</au><au>Kooreman, Loes F. S.</au><au>Quinn, Cecily</au><au>Floris, Giuseppe</au><au>Cserni, Gábor</au><au>van Diest, Paul J.</au><au>Lips, Esther H.</au><au>Schaapveld, Michael</au><au>Wesseling, Jelle</au><aucorp>Grand Challenge PRECISION consortium</aucorp><aucorp>Grand Challenge PRECISION consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>183</volume><issue>3</issue><spage>759</spage><epage>770</epage><pages>759-770</pages><issn>0167-6806</issn><issn>1573-7217</issn><eissn>1573-7217</eissn><abstract>Purpose
For optimal management of ductal carcinoma in situ (DCIS), reproducible histopathological assessment is essential to distinguish low-risk from high-risk DCIS. Therefore, we analyzed interrater reliability of histopathological DCIS features and assessed their associations with subsequent ipsilateral invasive breast cancer (iIBC) risk.
Methods
Using a case-cohort design, reliability was assessed in a population-based, nationwide cohort of 2767 women with screen-detected DCIS diagnosed between 1993 and 2004, treated by breast-conserving surgery with/without radiotherapy (BCS ± RT) using Krippendorff’s alpha (KA) and Gwet’s AC2 (GAC2). Thirty-eight raters scored histopathological DCIS features including grade (2-tiered and 3-tiered), growth pattern, mitotic activity, periductal fibrosis, and lymphocytic infiltrate in 342 women. Using majority opinion-based scores for each feature, their association with subsequent iIBC risk was assessed using Cox regression.
Results
Interrater reliability of grade using various classifications was fair to moderate, and only substantial for grade 1 versus 2 + 3 when using GAC2 (0.78). Reliability for growth pattern (KA 0.44, GAC2 0.78), calcifications (KA 0.49, GAC2 0.70) and necrosis (KA 0.47, GAC2 0.70) was moderate using KA and substantial using GAC2; for (type of) periductal fibrosis and lymphocytic infiltrate fair to moderate estimates were found and for mitotic activity reliability was substantial using GAC2 (0.70). Only in patients treated with BCS-RT, high mitotic activity was associated with a higher iIBC risk in univariable analysis (Hazard Ratio (HR) 2.53, 95% Confidence Interval (95% CI) 1.05–6.11); grade 3 versus 1 + 2 (HR 2.64, 95% CI 1.35–5.14) and a cribriform/solid versus flat epithelial atypia/clinging/(micro)papillary growth pattern (HR 3.70, 95% CI 1.34–10.23) were independently associated with a higher iIBC risk.
Conclusions
Using majority opinion-based scores, DCIS grade, growth pattern, and mitotic activity are associated with iIBC risk in patients treated with BCS-RT, but interrater variability is substantial. Semi-quantitative grading, incorporating and separately evaluating nuclear pleomorphism, growth pattern, and mitotic activity, may improve the reliability and prognostic value of these features.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32734520</pmid><doi>10.1007/s10549-020-05816-x</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-8940-2676</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2020-10, Vol.183 (3), p.759-770 |
| issn | 0167-6806 1573-7217 1573-7217 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7497690 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Breast cancer Breast Neoplasms - surgery Cancer research Carcinoma, Ductal Carcinoma, Ductal, Breast - surgery Carcinoma, Intraductal, Noninfiltrating - surgery Confidence intervals Epidemiology Female Fibrosis Football (College) Growth patterns Health aspects Humans Invasiveness Lumpectomy Mastectomy, Segmental Medical research Medical screening Medicine Medicine & Public Health Neoplasm Recurrence, Local Oncology Patients Pleomorphism Prognosis Radiation therapy Reproducibility of Results Surgery |
| title | Prognostic value of histopathological DCIS features in a large-scale international interrater reliability study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T14%3A59%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20value%20of%20histopathological%20DCIS%20features%20in%20a%20large-scale%20international%20interrater%20reliability%20study&rft.jtitle=Breast%20cancer%20research%20and%20treatment&rft.au=Groen,%20Emma%20J.&rft.aucorp=Grand%20Challenge%20PRECISION%20consortium&rft.date=2020-10-01&rft.volume=183&rft.issue=3&rft.spage=759&rft.epage=770&rft.pages=759-770&rft.issn=0167-6806&rft.eissn=1573-7217&rft_id=info:doi/10.1007/s10549-020-05816-x&rft_dat=%3Cgale_pubme%3EA635722895%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2442833706&rft_id=info:pmid/32734520&rft_galeid=A635722895&rfr_iscdi=true |