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PubMed · 14553843

Interpretive disparity among pathologists in breast sentinel lymph node evaluation.

Cory A Roberts·Peter D Beitsch·Craig E Litz·D Sue Hilton·Gene E Ewing·Edward Clifford·Walton Taylor·Marc R Hapke·Armineh Babaian·Imrana Khalid·Joe D Hall·Guy Lindberg·Kyle Molberg·Hossein Saboorian
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Abstract

BACKGROUND: Immunohistochemical staining on breast sentinel lymph nodes (SLN) is controversial. METHODS: Twenty-five SLN cases were reviewed by 10 pathologists (three academic, seven private) including 5 negative by both hematoxylin and eosin (H&E) and immunohistochemistry, 11 micrometastases (<2 mm) negative by H&E but positive by immunohistochemistry, and 8 micrometastases and 1 macrometastasis (>2 mm) positive for both H&E and immunohistochemistry. Answers included "positive," "negative," and "indeterminate" for each slide. RESULTS: The mean number of incorrect responses was 6.6 for immunohistochemistry and 5 for H&E. Twelve percent of cases were correct by all 10 pathologists; 80% of positive IHC cases had at least one pathologist score it incorrectly. As tumor cells decrease in number, incorrect responses increase. When tumor cells numbered less than 10, more than 30% of pathologists answered incorrectly. CONCLUSIONS: As tumor cells decrease in number pathologists' ability to recognize them decreases. We propose adding "indeterminate" to "positive" and "negative" when tumor cells number less than 10.

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Breast NeoplasmsColoring AgentsDiagnostic ErrorsEosine Yellowish-(YS)FemaleHematoxylinHistocytochemistryHumansImmunohistochemistryLymphatic MetastasisObserver VariationPathology, ClinicalReproducibility of ResultsSentinel Lymph Node BiopsyJournal Article

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Cory A Roberts, Peter D Beitsch, Craig E Litz, D Sue Hilton, Gene E Ewing, Edward Clifford, Walton Taylor, Marc R Hapke, Armineh Babaian, Imrana Khalid, Joe D Hall, Guy Lindberg, Kyle Molberg, Hossein Saboorian. 2003. Interpretive disparity among pathologists in breast sentinel lymph node evaluation.. https://doi.org/10.1016/s0002-9610(03)00268-x

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