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Comment & Response |

Discordant Interpretations of Breast Biopsy Specimens by Pathologists—Reply

Joann G. Elmore, MD, MPH1; Margaret S. Pepe, PhD2; Donald L. Weaver, MD3
[+] Author Affiliations
1University of Washington School of Medicine, Seattle
2Fred Hutchinson Cancer Research Center, Seattle
3University of Vermont School of Medicine, Burlington
JAMA. 2015;314(1):83-84. doi:10.1001/jama.2015.6239.
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In Reply We emphasized in our article that evaluating the overall diagnostic system was not our objective. We studied diagnostic variation at the level of the individual pathologist reviewing a routinely stained slide because this is the starting point of every microscopic diagnosis. We documented very high variation for breast atypia and ductal carcinoma in situ (DCIS). While our study also explored whether pathologists considered cases to be borderline or would request second opinions or additional information, these results were not reported in the article in detail but will be included in upcoming publications. Among the 6900 interpretations, 1803 (26.1%) were considered borderline and participants indicated they would desire a second opinion on 2451 (35.5%) of the interpretations.

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July 7, 2015
George Leonard, MD, PhD
1Madigan Army Medical Center, Tacoma, Washington
JAMA. 2015;314(1):82-83. doi:10.1001/jama.2015.6224.
July 7, 2015
William G. Finn, MD; E. Blair Holladay, PhD
1American Society for Clinical Pathology, Chicago, Illinois
JAMA. 2015;314(1):82. doi:10.1001/jama.2015.6230.
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