PDQ (Physician Data Query) is the National Cancer Institute’s source of comprehensive cancer information. It contains peer-reviewed, evidence-based cancer information summaries on treatment, supportive care, screening, prevention, genetics, and complementary and alternative medicine. The summaries are regularly updated by six editorial boards. The following PDQ summaries were recently updated:
Elmore JG, Nelson HD, Pepe MS, et al.: Variability in Pathologists' Interpretations of Individual Breast Biopsy Slides: A Population Perspective. Ann Intern Med 164 (10): 649-55, 2016.
Elmore JG, Tosteson AN, Pepe MS, et al.: Evaluation of 12 strategies for obtaining second opinions to improve interpretation of breast histopathology: simulation study. BMJ 353: i3069, 2016.
The PDQ Breast Cancer Screening summary was updated to include results of a study looking at the variability of pathologists’ diagnoses on the interpretation of breast biopsy specimens and a study evaluating strategies for improving interpretation of biopsies. In the first study, the authors expanded their results from the B-Path study, which showed that, while the overall agreement between individual pathologists’ interpretations and expert reference diagnoses was highest for invasive carcinoma, markedly lower levels of concordance were noted for DCIS and atypia. In this recent study, they applied Bayes’ theorem to estimate how diagnostic variability affects accuracy from the perspective of a U.S. woman aged 50 to 59 years having a breast biopsy. At the U.S. population level, it is estimated that 92.3% (confidence interval [CI], 91.4%–93.1%) of breast biopsy diagnoses would be verified by an expert reference consensus diagnosis, with 4.6% (CI, 3.9%–5.3%) of initial breast biopsies estimated to be overinterpreted and 3.2% (CI, 2.7%–3.6%) underinterpreted. In the second study, B-Path data were used to evaluate 12 strategies for obtaining second opinions to improve interpretation of breast histopathology. Accuracy improved significantly with all second opinion strategies, except for the strategy of limiting second opinions only to cases of invasive cancer. Accuracy improved regardless of the pathologists’ confidence in their diagnosis or their level of experience. While the second opinions improved accuracy, they did not completely eliminate diagnostic variability, especially in the challenging case of breast atypia. To review the summary, please use the following link: https://www.cancer.gov/types/breast/hp/breast-screening-pdq
The PDQ Cancer Genetics Editorial Board recently completed a comprehensive review of the Systemic therapy for ovarian cancer section of the Genetics of Breast and Gynecologic Cancers summary. The Board conducted a review of the published literature and revised the text and updated the citations. The section includes a summary of several studies that have examined the use of poly (ADP-ribose) polymerase (PARP) inhibitors in both treatment and maintenance therapy in patients with recurrent ovarian cancer, including individuals with BRCA1/BRCA2 pathogenic variants. To review the summary, please use the following link: https://www.cancer.gov/types/breast/hp/breast-ovarian-genetics-pdq#link/_2080
The PDQ Pediatric Treatment Board recently completed a comprehensive review of the Childhood Rhabdomyosarcoma Treatment summary. The Board conducted a review of the published literature and updated the citations. To review the summary, please use the following link: https://www.cancer.gov/types/soft-tissue-sarcoma/hp/rhabdomyosarcoma-treatment-pdq
The PDQ Integrative, Alternative, and Complementary Therapies Board published a new summary about Medicinal Mushrooms. A comprehensive review of published literature was performed and the summary was posted on Cancer.gov on 11/30/2016. To review the summary, please use the following link: https://www.cancer.gov/about-cancer/treatment/cam/hp/mushrooms-pdq