An analysis of screen-detected breast cancers in Leeds Teaching Hospital Trust, focussing on concordance in histological grading and other key prognostic factors
Association of Breast Surgery ePoster Library. Miscampbell M. 05/13/19; 257172; P130
Megan Miscampbell
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P130
Topic: Other
Introduction: Breast Cancer (BC) is the most common female cancer (1). Initial histological grading of BC at core needle biopsy (CNB) is a strong determinant for treatment scheme and an independent prognostic factor (2). Accurate grading can be difficult secondary to tumour heterogeneity and inter/intra-observer subjectivity. Overall concordance of CNB and surgical excision for patients diagnosed by the National Health Service Breast Screening Programme (NHS BSP) should be 70% as stated by the Royal College of Pathologists. Grades one, two and three are expected to be seen at a ratio of 3:5:2 respectively (3). This study compares data from Leeds Teaching Hospitals Trust (LTHT) with these existing, strict Quality Assurance (QA) standards. Methods : This retrospective audit includes 255 patients with screen-detected, invasive, B5b (4) BC found at CNB from January to December 2016 in LTHT. Kappa statistics determined strength of agreement between CNB and corresponding surgical excision. Symptomatic patients and patients who had received neo-adjuvant treatments were excluded. Results: Agreement of overall grade between CNB and excision = 77.78% (Cohen's kappa= 0.635, 95% CI 0.546-0.725). Grades one, two and three were assigned with a ratio of 32.66%: 50.81%: 16.53%. 100% agreement rates were achieved with the acquisition of ≥6 CNB's or when biopsy length ≥30mm Conclusions:LTHT are grading BCs accurately at CNB and meet the national QA standards for overall concordance and ratio of grades assigned. ≥6 CNB's should be taken with biopsy lengths ≥30mm in screen detected BC to optimise concordance between samples.
Topic: Other
Introduction: Breast Cancer (BC) is the most common female cancer (1). Initial histological grading of BC at core needle biopsy (CNB) is a strong determinant for treatment scheme and an independent prognostic factor (2). Accurate grading can be difficult secondary to tumour heterogeneity and inter/intra-observer subjectivity. Overall concordance of CNB and surgical excision for patients diagnosed by the National Health Service Breast Screening Programme (NHS BSP) should be 70% as stated by the Royal College of Pathologists. Grades one, two and three are expected to be seen at a ratio of 3:5:2 respectively (3). This study compares data from Leeds Teaching Hospitals Trust (LTHT) with these existing, strict Quality Assurance (QA) standards. Methods : This retrospective audit includes 255 patients with screen-detected, invasive, B5b (4) BC found at CNB from January to December 2016 in LTHT. Kappa statistics determined strength of agreement between CNB and corresponding surgical excision. Symptomatic patients and patients who had received neo-adjuvant treatments were excluded. Results: Agreement of overall grade between CNB and excision = 77.78% (Cohen's kappa= 0.635, 95% CI 0.546-0.725). Grades one, two and three were assigned with a ratio of 32.66%: 50.81%: 16.53%. 100% agreement rates were achieved with the acquisition of ≥6 CNB's or when biopsy length ≥30mm Conclusions:LTHT are grading BCs accurately at CNB and meet the national QA standards for overall concordance and ratio of grades assigned. ≥6 CNB's should be taken with biopsy lengths ≥30mm in screen detected BC to optimise concordance between samples.
P130
Topic: Other
Introduction: Breast Cancer (BC) is the most common female cancer (1). Initial histological grading of BC at core needle biopsy (CNB) is a strong determinant for treatment scheme and an independent prognostic factor (2). Accurate grading can be difficult secondary to tumour heterogeneity and inter/intra-observer subjectivity. Overall concordance of CNB and surgical excision for patients diagnosed by the National Health Service Breast Screening Programme (NHS BSP) should be 70% as stated by the Royal College of Pathologists. Grades one, two and three are expected to be seen at a ratio of 3:5:2 respectively (3). This study compares data from Leeds Teaching Hospitals Trust (LTHT) with these existing, strict Quality Assurance (QA) standards. Methods : This retrospective audit includes 255 patients with screen-detected, invasive, B5b (4) BC found at CNB from January to December 2016 in LTHT. Kappa statistics determined strength of agreement between CNB and corresponding surgical excision. Symptomatic patients and patients who had received neo-adjuvant treatments were excluded. Results: Agreement of overall grade between CNB and excision = 77.78% (Cohen's kappa= 0.635, 95% CI 0.546-0.725). Grades one, two and three were assigned with a ratio of 32.66%: 50.81%: 16.53%. 100% agreement rates were achieved with the acquisition of ≥6 CNB's or when biopsy length ≥30mm Conclusions:LTHT are grading BCs accurately at CNB and meet the national QA standards for overall concordance and ratio of grades assigned. ≥6 CNB's should be taken with biopsy lengths ≥30mm in screen detected BC to optimise concordance between samples.
Topic: Other
Introduction: Breast Cancer (BC) is the most common female cancer (1). Initial histological grading of BC at core needle biopsy (CNB) is a strong determinant for treatment scheme and an independent prognostic factor (2). Accurate grading can be difficult secondary to tumour heterogeneity and inter/intra-observer subjectivity. Overall concordance of CNB and surgical excision for patients diagnosed by the National Health Service Breast Screening Programme (NHS BSP) should be 70% as stated by the Royal College of Pathologists. Grades one, two and three are expected to be seen at a ratio of 3:5:2 respectively (3). This study compares data from Leeds Teaching Hospitals Trust (LTHT) with these existing, strict Quality Assurance (QA) standards. Methods : This retrospective audit includes 255 patients with screen-detected, invasive, B5b (4) BC found at CNB from January to December 2016 in LTHT. Kappa statistics determined strength of agreement between CNB and corresponding surgical excision. Symptomatic patients and patients who had received neo-adjuvant treatments were excluded. Results: Agreement of overall grade between CNB and excision = 77.78% (Cohen's kappa= 0.635, 95% CI 0.546-0.725). Grades one, two and three were assigned with a ratio of 32.66%: 50.81%: 16.53%. 100% agreement rates were achieved with the acquisition of ≥6 CNB's or when biopsy length ≥30mm Conclusions:LTHT are grading BCs accurately at CNB and meet the national QA standards for overall concordance and ratio of grades assigned. ≥6 CNB's should be taken with biopsy lengths ≥30mm in screen detected BC to optimise concordance between samples.
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