Tumor architecture exerts no bias on nuclear grading in breast cancer diagnosis

Mora, Braulio; Bombari, Dario; Schaefer, Stephan C.; Schmidt, Marcus; Delaloye, Jean-Francois; Mast, Fred W.; Lehr, Hans-Anton (2012). Tumor architecture exerts no bias on nuclear grading in breast cancer diagnosis. Virchows Archiv, 461(4), pp. 399-403. Berlin: Springer 10.1007/s00428-012-1304-1

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We recently reported that nuclear grading in prostate cancer is subject to a strong confirmation bias induced by the tumor architecture. We now wondered whether a similar bias governs nuclear grading in breast carcinoma. An unannounced test was performed at a pathology conference. Pathologists were asked to grade nuclei in a PowerPoint presentation. Circular high power fields of 27 invasive ductal carcinomas were shown, superimposed over low power background images of either tubule-rich or tubule-poor carcinomas. We found (a) that diagnostic reproducibility of nuclear grades was poor to moderate (weighed kappa values between 0.07 and 0.54, 27 cases, 44 graders), but (b) that nuclear grades were not affected by the tumor architecture. We speculate that the categorized grading in breast cancer, separating tubule formation, nuclear pleomorphism, and mitotic figure counts in a combined three tier score, prevents the bias that architecture exerts on nuclear grades in less well-controlled situations.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Service Sector > Institute of Pathology
07 Faculty of Human Sciences > Institute of Psychology > Cognitive Psychology, Perception and Methodology

UniBE Contributor:

Bombari, Dario; Schäfer, Stephan; Mast, Fred and Lehr, Hans-Anton


500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology








Factscience Import

Date Deposited:

04 Oct 2013 14:32

Last Modified:

30 May 2014 09:37

Publisher DOI:


PubMed ID:


Web of Science ID:



https://boris.unibe.ch/id/eprint/12441 (FactScience: 218785)

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