{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:53:10Z","timestamp":1761540790432,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1985,12]]},"abstract":"<jats:p>The consistency of histological diagnosis of breast lesions by members of the panel was studied using a simplified six point classification system that covered the range from normal tissue to invasive carcinoma. In a representative set of 40 sections of the range of breast disease included in the Trial for Early Detection of Breast Carcinoma (the consecutive series), there was, overall, 82% agreement between the diagnoses submitted by members of the panel: diagnosis was virtually consistent (99% agreement) for frankly invasive carcinoma, but there was much greater variability in the diagnosis of borderline lesions. Diagnostic consistency was greatly improved when two categories only (benign and malignant) were considered (94% agreement). The diagnostic consistency of individual pathologists was studied by recirculating the sections: the overall agreement was 78% and, again, most of the inconsistencies occurred when borderline lesions were diagnosed. Additional studies were undertaken on borderline lesions that had been flagged during the first two years of the trial (the borderline series). Unsurprisingly, there was less agreement among the pathologists when all six diagnostic categories were used (70% and 77% for the specimens from the first and second years, respectively), but consistency was greatly improved when classification was simplified to either benign or malignant (86% and 91%, respectively). The diagnoses submitted by individual pathologists were found to deviate from the \"majority\" diagnosis to a relatively minor extent: each pathologist was generally consistent in either under-diagnosing or overdiagnosing in both the consecutive and borderline series.<\/jats:p>","DOI":"10.1136\/jcp.38.12.1358","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"1358-1365","source":"Crossref","is-referenced-by-count":40,"title":["Observer variability in reporting of breast lesions."],"prefix":"10.1136","volume":"38","author":[{"given":"J S","family":"Beck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1985,12,1]]},"reference":[{"key":"ref_1","first-page":"349","article-title":"Ten to fourteen year effects of breast cancer screening on mortality","volume":"69","author":"Shapiro, S.; Venet, W.; Strax, P.; Venet, L.; Roeser, R.","year":"1982","unstructured":"Shapiro S, Venet W, Strax P, Venet L, Roeser R. Ten to fourteen year effects of breast cancer screening on mortality. Journal of the National Cancer Institute 1982;69:349-55.","journal-title":"Journal of the National Cancer Institute"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0140-6736(85)92204-4","article-title":"Reduction in breast cancer mortality by mass screening with mammography: First results of a randomised trial in two Swedish counties","volume":"i:","author":"Tabar, L.; Gad, A.; Holmberg, L.H.","year":"1985","unstructured":"Tabar L, Gad A, Holmberg LH, et al. Reduction in breast cancer mortality by mass screening with mammography: First results of a randomised trial in two Swedish counties. 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Trial of early detection of breast cancer: description of method"},{"key":"ref_4","first-page":"193","article-title":"Lobular carcinoma in-situ (lobular neoplasia) of the breast","author":"Anderson, J.A.; Fechner, R.E.; Lattes, R.; Rosen, P.P.; Toker, C.","year":"1980","unstructured":"Anderson JA, Fechner RE, Lattes R, Rosen PP, Toker C. Lobular carcinoma in-situ (lobular neoplasia) of the breast. In: Sommers SC, ed. New York: Appleton Century Crofts, 1980:193-223."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/001316446002000104","article-title":"A coefficient of agreement for nominal scales","volume":"20","author":"Cohen, J.","year":"1960","unstructured":"Cohen J. A coefficient of agreement for nominal scales. Educational Psychological Measurements 1960;20:37-46.","journal-title":"Educational Psychological Measurements"},{"key":"ref_6","article-title":"Statistical methods for rates and proportions","author":"Fleiss, J.L.","year":"1981","unstructured":"Fleiss JL. Statistical methods for rates and proportions. 2nd ed. Chichester: Wiley and Sons, 1981.","edition":"2nd ed"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1037\/0033-2909.86.5.974","article-title":"The large sample variance of kappa in the case of different sets of raters","volume":"86","author":"Fleiss, J.L.; Nee, J.C.M.; Landis, JR","year":"1979","unstructured":"Fleiss JL, Nee JCM, Landis JR. The large sample variance of kappa in the case of different sets of raters. Psychol Bull 1979;86:974-7.","journal-title":"Psychol Bull"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis, JR, Koch; G.G.","year":"1977","unstructured":"Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.","journal-title":"Biometrics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1136\/jcp.36.4.385","article-title":"Observer variation in the histological grading of rectal carcinoma","volume":"36","author":"Thomas, G.H.D.; Dixon, M.F.; Smeeton, N.C.; Williams, N.S.","year":"1983","unstructured":"Thomas GHD, Dixon MF, Smeeton NC, Williams NS. Observer variation in the histological grading of rectal carcinoma. J Clin Pathol 1983;36:385-91.","journal-title":"J Clin Pathol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1136\/jcp.37.9.993","article-title":"Combined external quality assessment of cytology and histology opinions: a pilot scheme for a cluster of five laboratories","volume":"37","author":"Husain, O.A.N.; Butler, B.E.; Woodford, F.P.","year":"1984","unstructured":"Husain OAN, Butler BE, Woodford FP. Combined external quality assessment of cytology and histology opinions: a pilot scheme for a cluster of five laboratories. J Clin Pathol 1984;37:993-1001.","journal-title":"J Clin Pathol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1136\/jcp.36.4.392","article-title":"Histopathological systems of breast cancer classification: reproducibility and clinical significance","volume":"36","year":"1983","unstructured":"Stenkvist B, Bengstsson E, Eriksson 0, Jarkraus T, Nardin B, Westerman-Naeser S. Histopathological systems of breast cancer classification: reproducibility and clinical significance. J Clin Pathol 1983;36:392-8.","journal-title":"J Clin Pathol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0046-8177(83)80175-0","article-title":"Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications","volume":"14","author":"Riddell, R.H.; Goldman, H.; Ransohoff, D.F.","year":"1983","unstructured":"Riddell RH, Goldman H, Ransohoff DF, et al. Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol 1983;14:931-68.","journal-title":"Hum Pathol"},{"key":"ref_13","first-page":"640","article-title":"Report of the working group to review the National Cancer Institute-American Cancer Society breast cancer detection demonstration projects","volume":"62","author":"Beahrs, O.H.; Shapiro, S.; Smart, C.","year":"1979","unstructured":"Beahrs OH, Shapiro S, Smart C. Report of the working group to review the National Cancer Institute-American Cancer Society breast cancer detection demonstration projects. Journal of the National Cancer Institute 1979;62:640-709.","journal-title":"Journal of the National Cancer Institute"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1093\/ajcp\/60.6.799","article-title":"Increased detection ofoccult breast carcinoma after more thorough histological examination of breast biopsies","volume":"60","author":"Patchefsky, A.S.; Potok, J.; Hoch, W.S.; Libshitz, H.I.","year":"1973","unstructured":"Patchefsky AS, Potok J, Hoch WS, Libshitz HI. Increased detection ofoccult breast carcinoma after more thorough histological examination of breast biopsies. 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