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Comment & Response
July 7, 2015

Discordant Interpretations of Breast Biopsy Specimens by Pathologists

Author Affiliations
  • 1American Society for Clinical Pathology, Chicago, Illinois
JAMA. 2015;314(1):82. doi:10.1001/jama.2015.6230

To the Editor Dr Elmore and colleagues1 reported levels of diagnostic concordance among pathologists in the interpretation of breast biopsy specimens. We believe that the study was flawed in its design, and the conclusions may create unnecessary quality concerns.

The study was not designed to evaluate the diagnostic systems currently in place to provide diagnoses by pathologists, but instead to evaluate individual pathologists under unrealistically restrictive conditions. In actual practice, inter-observer consultation is commonplace, and an evolving norm is for pathology practices to mandate that certain types of abnormalities (including the types that were the subject of the study) be reviewed by multiple pathologists as part of formal quality assurance programs.2