ArticleEuropean journal of cancer (Oxford, England : 1990)2017
The diagnostic challenge of low-grade ductal carcinoma in situ.
Article in European journal of cancer (Oxford, England : 1990), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Diagnosis of Extensive DCIS with Progressive Microcalcifications over a Period of 11 Years.Diagnostics (Basel, Switzerland) · 2026Article
- Mechanosensitive TRPV4 immunohistochemistry improves deep learning-based classification of ductal carcinoma in situ beyond H&E morphology.The journal of pathology. Clinical research · 2026Article
- Characterizing Interpretive and Diagnostic Competency Development in Pathology Training.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2025Article
- Preoperative MRI to Predict Upstaging of DCIS to Invasive Cancer at Surgery.Annals of surgical oncology · 2025Observational
- Incidence trends of ductal carcinoma in situ in New Zealand women between 1999 and 2022.Breast cancer research and treatment · 2025Article
- Do Physicians Remember Cases? Implications for Longitudinal Designs in Medical Research and Competency Assessment.Research methods in medicine & health sciences · 2024Article
- Machine learning classification of diagnostic accuracy in pathologists interpreting breast biopsies.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- From Image to Diagnosis: Characterizing Sources of Error in Histopathologic Interpretation.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2023Article
- Should low-risk DCIS lose the cancer label? An evidence review.Breast cancer research and treatment · 2023Review
- Zoom behavior during visual search modulates pupil diameter and reflects adaptive control states.PloS one · 2023Article
- Unresected screen-detected ductal carcinoma in situ: Outcomes of 311 women in the Forget-Me-Not 2 study.Breast (Edinburgh, Scotland) · 2022Article
- Abbreviated protocol combining quantitative diffusion-weighted imaging: a new strategy increasing diagnostic accuracy for breast magnetic resonance imaging?Gland surgery · 2021Article
- Improving DCIS diagnosis and predictive outcome by applying artificial intelligence.Biochimica et biophysica acta. Reviews on cancer · 2021Review
- Variability in grading of ductal carcinoma in situ among an international group of pathologists.The journal of pathology. Clinical research · 2021Article
- Comparison of the ductal carcinoma in situ between White Americans and Chinese Americans.Medicine · 2021Observational
- Multi-Omics Marker Analysis Enables Early Prediction of Breast Tumor Progression.Frontiers in genetics · 2021Article
- Eye tracking reveals expertise-related differences in the time-course of medical image inspection and diagnosis.Journal of medical imaging (Bellingham, Wash.) · 2020Article
- Inter-observer reproducibility of classical lobular neoplasia (B3 lesions) in preoperative breast biopsies: a study of the Swiss Working Group of breast and gynecopathologists.Journal of cancer research and clinical oncology · 2020Observational
- A retrospective alternative for active surveillance trials for ductal carcinoma in situ of the breast.International journal of cancer · 2020Review
- Subtype-specific characterization of breast cancer invasion using a microfluidic tumor platform.PloS one · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundDiagnostic agreement among pathologists is 84% for ductal carcinoma in situ (DCIS). Studies of interpretive variation according to grade are limited.
methodsA national sample of 115 pathologists interpreted 240 breast pathology test set cases in the Breast Pathology Study and their interpretations were compared to expert consensus interpretations. We assessed agreement of pathologists' interpretations with a consensus reference diagnosis of DCIS dichotomised into low- and high-grade lesions. Generalised estimating equations were used in logistic regression models of rates of under- and over-interpretation of DCIS by grade.
resultsWe evaluated 2097 independent interpretations of DCIS (512 low-grade DCIS and 1585 high-grade DCIS). Agreement with reference diagnoses was 46% (95% confidence interval [CI] 42-51) for low-grade DCIS and 83% (95% CI 81-86) for high-grade DCIS. The proportion of reference low-grade DCIS interpretations over-interpreted by pathologists (i.e. categorised as either high-grade DCIS or invasive cancer) was 23% (95% CI 19-28); 30% (95% CI 26-34) were interpreted as a lower diagnostic category (atypia or benign proliferative). Reference high-grade DCIS was under-interpreted in 14% (95% CI 12-16) of observations and only over-interpreted 3% (95% CI 2-4).
conclusionGrade is a major factor when examining pathologists' variability in diagnosing DCIS, with much lower agreement for low-grade DCIS cases compared to high-grade. These findings support the hypothesis that low-grade DCIS poses a greater interpretive challenge than high-grade DCIS, which should be considered when developing DCIS management strategies.
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