Title |
Discrepancies in the diagnosis of intraductal proliferative lesions of the breast and its management implications: results of a multinational survey
|
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Published in |
Virchows Archiv, October 2006
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DOI | 10.1007/s00428-006-0245-y |
Pubmed ID | |
Authors |
Mohiedean Ghofrani, Beatriz Tapia, Fattaneh A. Tavassoli |
Abstract |
To measure discrepancies in diagnoses and recommendations impacting management of proliferative lesions of the breast, a questionnaire of five problem scenarios was distributed among over 300 practicing pathologists. Of the 230 respondents, 56.5% considered a partial cribriform proliferation within a duct adjacent to unequivocal ductal carcinoma in situ (DCIS) as atypical ductal hyperplasia (ADH), 37.7% of whom recommended reexcision if it were at a resection margin. Of the 43.5% who diagnosed the partially involved duct as DCIS, 28.0% would not recommend reexcision if the lesion were at a margin. When only five ducts had a partial cribriform proliferation, 35.7% considered it as DCIS, while if >or=20 ducts were so involved, this figure rose to 60.4%. When one duct with a complete cribriform pattern measured 0.5, 1.5, or 4 mm, a diagnosis of DCIS was made by 22.6, 31.3, and 94.8%, respectively. When multiple ducts with flat epithelial atypia were at a margin, 20.9% recommended reexcision. Much of these discrepancies arise from the artificial separation of ADH and low-grade DCIS and emphasize the need for combining these two under the umbrella designation of ductal intraepithelial neoplasia grade 1 (DIN 1) to diminish the impact of different terminologies applied to biologically similar lesions. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 13 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 2 | 15% |
Researcher | 2 | 15% |
Student > Ph. D. Student | 2 | 15% |
Student > Doctoral Student | 1 | 8% |
Student > Bachelor | 1 | 8% |
Other | 4 | 31% |
Unknown | 1 | 8% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 77% |
Agricultural and Biological Sciences | 1 | 8% |
Unknown | 2 | 15% |