Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision

Objective: To assess the interobserver variability in HER2 immunohistochemical stain interpretation by pathologists of different strata of experience. Study Design: Cross-sectional observational study. Place and Duration of Study: Chughtai Institute of Pathology at Lahore, during a three-month inter...

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Main Author: Hira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai
Format: Article
Language:English
Published: Riphah International University, Islamabad 2025-07-01
Series:Journal of Islamic International Medical College
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Online Access:https://journals.riphah.edu.pk/index.php/jiimc/article/view/2303
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author Hira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai
author_facet Hira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai
author_sort Hira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai
collection DOAJ
description Objective: To assess the interobserver variability in HER2 immunohistochemical stain interpretation by pathologists of different strata of experience. Study Design: Cross-sectional observational study. Place and Duration of Study: Chughtai Institute of Pathology at Lahore, during a three-month interval from 01/6/2024 to 31/8/2024. Materials and Methods: Fifty cases (n=50) of invasive breast cancer were included by random probability sampling and blocks were retrieved through respective biopsy reports by the laboratory information system. All the cases of ductal carcinoma in situ (DCIS) and salivary gland-like tumors of the breast were excluded. HER2 antibody was applied to these cases and interpreted by four histopathologists with varying years of reporting experience. Interobserver variability was observed by using the Cohen's and Fleiss kappa tests. A p-value of ≤0.05 was considered statistically significant. Results: All patients were female, with a mean age of 46.3 years ± 12.87. The highest concordance was observed at a score of 3, while the greatest discordance occurred at a score of 2, with kappa values of 0.81 and 0.35, respectively, and a p-value of <0.01. Conclusion: The highest interobserver variability was observed in the assessment of HER2 score 2, highlighting the challenges in interpreting equivocal cases.
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spelling doaj-art-04e2583bcab448e1bfeda9931928063b2025-08-20T02:43:43ZengRiphah International University, IslamabadJournal of Islamic International Medical College1815-40182410-54222025-07-0120280852700Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment PrecisionHira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai0https://orcid.org/0009-0009-2164-4669Chughtai Institute of Pathology, LahoreObjective: To assess the interobserver variability in HER2 immunohistochemical stain interpretation by pathologists of different strata of experience. Study Design: Cross-sectional observational study. Place and Duration of Study: Chughtai Institute of Pathology at Lahore, during a three-month interval from 01/6/2024 to 31/8/2024. Materials and Methods: Fifty cases (n=50) of invasive breast cancer were included by random probability sampling and blocks were retrieved through respective biopsy reports by the laboratory information system. All the cases of ductal carcinoma in situ (DCIS) and salivary gland-like tumors of the breast were excluded. HER2 antibody was applied to these cases and interpreted by four histopathologists with varying years of reporting experience. Interobserver variability was observed by using the Cohen's and Fleiss kappa tests. A p-value of ≤0.05 was considered statistically significant. Results: All patients were female, with a mean age of 46.3 years ± 12.87. The highest concordance was observed at a score of 3, while the greatest discordance occurred at a score of 2, with kappa values of 0.81 and 0.35, respectively, and a p-value of <0.01. Conclusion: The highest interobserver variability was observed in the assessment of HER2 score 2, highlighting the challenges in interpreting equivocal cases.https://journals.riphah.edu.pk/index.php/jiimc/article/view/2303asco guidelines, equivocal cases, human epidermal growth factor receptor 2, interobserver variability, invasive breast cancer.
spellingShingle Hira Batool, Sameen Afzal, Fatima Khalid, Saira Javeed, Zonaira Rathore, Akhter Sohail Chughtai
Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
Journal of Islamic International Medical College
asco guidelines, equivocal cases, human epidermal growth factor receptor 2, interobserver variability, invasive breast cancer.
title Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
title_full Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
title_fullStr Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
title_full_unstemmed Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
title_short Interobserver Variability in HER2 Breast Biomarker Reporting: Implications for Diagnostic Consistency and Treatment Precision
title_sort interobserver variability in her2 breast biomarker reporting implications for diagnostic consistency and treatment precision
topic asco guidelines, equivocal cases, human epidermal growth factor receptor 2, interobserver variability, invasive breast cancer.
url https://journals.riphah.edu.pk/index.php/jiimc/article/view/2303
work_keys_str_mv AT hirabatoolsameenafzalfatimakhalidsairajaveedzonairarathoreakhtersohailchughtai interobservervariabilityinher2breastbiomarkerreportingimplicationsfordiagnosticconsistencyandtreatmentprecision