{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:48:59Z","timestamp":1793134139906,"version":"4.5.0"},"reference-count":92,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T00:00:00Z","timestamp":1592784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Since most patients with ductal carcinoma in situ (DCIS) of the breast are treated upon diagnosis, evidence on its natural progression to invasive carcinoma is limited. It is estimated that around half of the screen-detected DCIS lesions would have remained indolent if they had never been detected. Many patients with DCIS are therefore probably overtreated. Four ongoing randomized noninferiority trials explore active surveillance as a treatment option. Eligibility for these trials is mainly based on histopathologic features. Hence, the call for reproducible histopathologic assessment has never sounded louder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Here, the available classification systems for DCIS are discussed in depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This comprehensive review illustrates that histopathologic evaluation of DCIS is characterized by significant interobserver variability. Future digitalization of pathology, combined with development of deep learning algorithms or so-called artificial intelligence, may be an innovative solution to tackle this problem. However, implementation of digital pathology is not within reach for each laboratory worldwide. An alternative classification system could reduce the disagreement among histopathologists who use \u201cconventional\u201d light microscopy: the introduction of dichotomous histopathologic assessment is likely to increase interobserver concordance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reproducible histopathologic assessment is a prerequisite for robust risk stratification and adequate clinical decision-making. Two-tier histopathologic assessment might enhance the quality of care.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajcp\/aqaa077","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T11:07:49Z","timestamp":1587640069000},"page":"596-609","source":"Crossref","is-referenced-by-count":31,"title":["Interobserver Variability in Ductal Carcinoma In Situ of the Breast"],"prefix":"10.1093","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-928X","authenticated-orcid":false,"given":"Mieke R","family":"Van Bockstal","sequence":"first","affiliation":[{"name":"Department of Pathology, Brussels, Belgium"},{"name":"Breast Clinic, Brussels, Belgium"},{"name":"Department of Medical Oncology, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Berli\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium"},{"name":"Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois P","family":"Duhoux","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium"},{"name":"Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium"},{"name":"Institut de Recherche Exp\u00e9rimentale et Clinique, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Galant","sequence":"additional","affiliation":[{"name":"Department of Pathology, Brussels, Belgium"},{"name":"Department of Medical 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