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This study evaluated BRAF IHC staining quality and interpretation in general pathology laboratories through a nationwide proficiency test (PT) in Taiwan, focusing on the most commonly encountered thyroid neoplasm and colorectal cancer. This PT was organized by the Taiwan Society of Pathology using a tissue microarray, containing six tumor cores with confirmed\n                    <jats:italic>BRAF<\/jats:italic>\n                    mutation status and one positive control. Participating laboratories performed BRAF IHC staining and interpretation independently, with results centrally reviewed for concordance, accuracy, and staining quality. Twenty-six pathology laboratories participated. Two laboratories failed the initial control check. Among the remaining 24, 17 (70.83%) demonstrated optimal staining, while 5 (20.83%) showed over-staining and 2 (8.33%) under-staining. No significant associations were found between staining quality and antibody clones, platforms, dilution folds, or assay types. Interpretation was highly concordant (100% agreement and accuracy) for tissues with 3\u2009+\u2009or negative staining. However, discrepancies arose in tissues with 2\u2009+\u2009intensity (50% positive, 41.67% negative, 8.33% equivocal) and 1\u2009+\u2009intensity (83.33% disagreement with test results). The overall accuracy was 79.2%, with sensitivity at 58.3% and specificity at 100%. Under-calling was frequent in cases with 1\u2009+\u2009staining (33 cores across 23 laboratories) and 2\u2009+\u2009staining (3 cores across 3 laboratories). Our study highlights the importance of optimizing staining quality and reinforcing education on interpretation criteria. To minimize false-negative results, we recommend molecular confirmation for all cases exhibiting diffusely weak staining.\n                  <\/jats:p>","DOI":"10.1007\/s00428-025-04192-5","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T06:19:29Z","timestamp":1753078769000},"page":"1125-1135","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Proficiency test of BRAF immunohistochemistry as a surrogate marker of p.V600E mutation: Assessment of staining and interpretation quality in Taiwan"],"prefix":"10.1007","volume":"488","author":[{"given":"Yun-An","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyie-Yu","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Yi","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huang-Chun","family":"Lien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-2784","authenticated-orcid":false,"given":"Jen-Fan","family":"Hang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"issue":"3","key":"4192_CR1","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1038\/s41571-023-00852-0","volume":"21","author":"AJ Hanrahan","year":"2024","unstructured":"Hanrahan AJ, Chen Z, Rosen N, Solit DB (2024) BRAF - a tumour-agnostic drug target with lineage-specific dependencies. 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