Descriptive results are expressed in numbers and percentages. Proportions with consistent findings were calculated as a percentage of tumors with the same diagnosis in shock biopsy and Mohs excision samples. The correlation between fractions was calculated from Cohen`s kappa coefficients. The full agreement was considered Kappa`s score of 1. Kappa Values The success rate of MMS depends on accurate microscopic analysis of samples. The mms surgeon performs the histopathological check and is able to translate the abnormal results into an appropriate sequential removal of the tumor. However, there are large differences in the literature in terms of the percentage of agreement between the histological diagnosis of incision biopsies and the histological diagnosis that occurs in the case of complete tumor excision. Previous studies have shown a moderate match between 51.1% and 82% between the NMSC subtype on incision biopsies and subsequent surgical excision.4-7 In most cases, there was a weak agreement between the first diagnosis of NMSC and the definitive diagnosis of Mohs tumor layer for both dermatopathe and Mohs surgeon. This agreement appears to be lower than the percentages of consent reported in similar studies. Haws et al.6 found an 81% histological match between punch and shaving biopsies and their edge excision.
In a recent study, Roozeboom et al.4 found a lower percentage of concordance (60.9%) between the BCC subtype on a punch biopsy and the following subtype of the total lesion. Izikson et al.5 compared the biopsy diagnosis and Mohs “Debulking” slides in 513 cases of primary NMSC and found concordance in 51.1% of aggressive and non-aggressive tumor subtypes. Another study of Mohs resection of CVC reported a lower accuracy rate of 10% for biopsy samples. One study showed a 67.1% match between the histological subtype of BCC on a shock biopsy and the following excision samples in recurrent BCC.4 methods: to remedy this problem, we examined pathological findings in 2004. , enrolled in the Radiologic Diagnostic Oncology Group 5, a randomized multicenter study to determine the role of NBC and fine biopsy in the evaluation of non-palpable breast lesions. Slides of NBC samples were first diagnosed by pathologists at the 22 participating institutions (local diagnosis) and then sent to pathologists for central examination (central diagnosis). Local and central diagnoses were compared. Results: Overall, the central diagnosis and local diagnosis were consistent in 1925 cases (96%), indicating excellent agreement by statistical analysis of kappa (kappa -0.90; 95% confidence interval 0.88-0.92). The degree of adequacy between local and central pathologists did not vary with the image guidance system (stereo-tactical vs.
ultrasound) or with mammographic results (soft tissue density versus micro-limestone). The degree of diagnostic compliance observed for CNB was comparable to that observed in 596 open surgical biopsies in patients in this study and subjected to a central pathology examination (93% concordance; kappa -0.89, 95% confidence interval 0.86-0.92). The agreement between preoperative biopsy and intraoperative histological subtypes of NMSC by Surgeon Mohs was correct (kappa-0.22). This value was slightly lower than the intraoperative subtype detected by the dermatopathologist (kappa-0.24). Moderate concordance (kappa-0.58) was found between the histological subtypes of the intraoperative sample, interpreted by both the dermatologist and the mohs surgeon. Background: The core needle biopsies (CNBs) photographed are often used as the first sampling method for non-palpable and mammographic breast lesions. Although previous studies have shown that this method is a highly sensitive and accurate method for detecting breast cancer, the degree of diagnostic compliance between pathologists in the NBC analysis has not yet been studied in detail.