Expertise vs evidence in assessment of breast biopsies: An atypical science
Menée aux Etats-Unis auprès de 3 puis 115 pathologistes ayant chacun analysé 60 biopsies mammaires, cette étude évalue la concordance des diagnostics émis
Breast biopsies are performed in 1.6 million women in the United States each year1 and yield results ranging from benign to atypical hyperplasia to carcinoma in situ to invasive cancer, each with specific implications for subsequent management. The critical tissue diagnosis from the anatomic pathologist directly determines patient management. That diagnosis is based on morphology, the relationship between cellular and architectural features, devoid of any molecular evidence. The accuracy of the pathologist’s diagnoses is relatively understudied and represents an important knowledge gap at a time when medicine is becoming ever more evidence-based.
JAMA , éditorial en libre accès, 2014