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Diagnostic concordance of phyllodes tumour of the breast
- Source :
- HistopathologyReferences. 79(4)
- Publication Year :
- 2021
-
Abstract
- Background: Phyllodes tumours (PT) are rare and distinct breast tumours, which span a morphological continuum. Classification into benign, borderline and malignant categories reflects their biology and clinical behaviour and is essential to guide management. This study aims to assess the diagnostic agreement of PT using the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology external quality assurance (EQA) scheme data. Methods: 26 PTs were identified in the EQA scheme, which were diagnosed by an average of 607 participants/circulation. Data on diagnostic categories were collected, and representative slides were reviewed. The level of concordance between reporting pathologists was assessed. Results: There were 14 benign, 6 borderline and 6 malignant PT. The overall rate of diagnosis agreement was 86% when analysed as benign lesions, borderline PT and malignant lesions, which decreased to 79% when diagnosed as PT (irrespective of grade) and to 63% when the diagnosis was further refined to PT categories (benign, borderline and malignant PTs). The highest agreement rate was observed in malignant PT (86%) and the lowest in borderline PT (42%). Malignant heterologous elements, stromal overgrowth and leaf-like architecture are features associated with higher concordance rates. Lower priority features were stromal expansion, clefting, and multinodularity. Conclusion: The concordance of PT diagnosis, as an entity, is high, but its classification into benign, borderline and malignant has variable agreement levels, with borderline tumours having the lowest concordance rate. More research to refine the diagnostic criteria for categorisation of PT is warranted to improve concordance between pathologists.
- Subjects :
- 0301 basic medicine
concordance
medicine.medical_specialty
Histology
Concordance
Diagnostic concordance
Breast Neoplasms
Breast pathology
Lower priority
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Phyllodes Tumor
Phyllodes tumours
Medicine
Breast screening
Humans
Observer Variation
business.industry
Breast tumours
General Medicine
National health service
Pathologists
030104 developmental biology
diagnostic agreement Short Title: Phyllodes tumour diagnostic concordance 2
030220 oncology & carcinogenesis
fibroepithelial lesions
Female
Radiology
business
Phyllodes tumour
Subjects
Details
- ISSN :
- 13652559 and 03090167
- Volume :
- 79
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- HistopathologyReferences
- Accession number :
- edsair.doi.dedup.....ca4f71b63c7329e5e5d82a99e0bfc420