Low-Grade Ductal Carcinoma in Situ

Sarah A. Alghamdi, Kritika Krishnamurthy, Sofia A. Garces Narvaez, Khaled J. Algashaamy, Jessica Aoun, Isildinha M. Reis, Monica A. Recine, Merce Jorda, Robert J. Poppiti, Carmen R. Gomez-Fernandez

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objectives: We aimed to determine the interobserver reproducibility in diagnosing low-grade ductal carcinoma in situ (DCIS). We also aimed to compare the interobserver variability using a proposed two-tiered grading system as opposed to the current three-tiered system. Methods: Three expert breast pathologists and one junior pathologist identified low-grade DCIS from a set of 300 DCIS slides. Months later, participants were asked to grade the 300 cases using the standard three-tiered system. Results: Using the two-tiered system, interobserver agreement among breast pathologists was considered moderate (κ = 0.575). The agreement was similar (κ = 0.532) with the junior pathologist included. Using the three-tiered system, pathologists' agreement was poor (κ = 0.235). Conclusions: Pathologists' reproducibility on diagnosing low-grade DCIS showed moderate agreement. Experience does not seem to influence reproducibility. Our proposed two-tiered system of low vs nonlow grade, where the intermediate grade is grouped in the nonlow category has shown improved concordance.

Original languageEnglish (US)
Pages (from-to)360-367
Number of pages8
JournalAmerican journal of clinical pathology
Issue number3
StatePublished - Feb 8 2020


  • Ductal carcinoma in situ
  • Grading system
  • Interobserver reproducibility
  • Low-grade DCIS

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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