REPRODUCTIBILITY OF HISTOLOGICAL GRADING OF INVASIVE BREAST-CARCINOMA

In the framework of the quality assurance of the pathologists involved in the screening campaign it was proposed to test the reproducibility of the classical SCARFF, BLOOM and RICHARDSON (SBR) grade and the ELS TON-ELLIS grade (E-E) mentioned in the recent European recommendations Twenty-four cases of invasive carcinoma were analyzed by 21 pathologi sts. Sixty-eight per cent agreement was obtained for the SBR grant and 69 % for the E-E grade in the first round and vice versa in the secon d round. The mean value of the kappa test,vas 0.54 with SBR and 0.53 w ith E-E. The differentiation of the carcinoma was found to be the most reliable index (kappa scope greater than 0.5), followed by the mitoti c index (kappa score = 0.39 for SBR and 0.36 for E-E), and the nuclear polymorphism obtained the lowest score (kappa score ranging from 0.33 to 0.38). In our hands, the use of the E-E grade did not improve the reproducibility particularly for the mitotic index. Our results sugges t however that the reproducibility may be improved by training.