The ER/PR benchmarks are those published in the notes section of the checklist 
question.  We use the lowest numbers of the ranges.  We track , patient age, 
cancer type, tumor grade, and positive or negative results, then just run the 
numbers. We also add in some extras, such as cases positive for one antibody, 
and negative for another, just for tracking purposes only. 
For Interobserver variability, at the advice of CAP, we simply allow each 
pathologist to independently read the CAP ER/PR (PMB) survey and record their 
answers.  Those are compared with the correct answers and with each other.  
They must achieve <10% variability, or be enrolled in performance improvement 
until they can.
I hope this helps.
Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874

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Subject: Histonet Digest, Vol 153, Issue 19

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Today's Topics:

   1. CAP ANP.22970 Query (Joanne Clark)


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Message: 1
Date: Mon, 22 Aug 2016 20:05:00 +0000
From: Joanne Clark <jcl...@pcnm.com>
To: "histonet@lists.utsouthwestern.edu"
        <histonet@lists.utsouthwestern.edu>
Subject: [Histonet] CAP ANP.22970 Query
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        <7a7bdd92b984e847a7e71bc9c00a66d31277c...@s11maild034n2.sh11.lan>
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Hi Histonetters, we are wondering what everyone else out there is doing to be 
compliant with the following requirement?  We do ER and PR by IHC  but dont 
know what published benchmarks are out there to compare ourselves to.  Also, 
how do you record interobserver variability amongst the pathologists?  Any 
insights into this would be appreciated.



ANP.22970 Annual Result Comparison Phase II For immunohistochemical and 
FISH/ISH tests that provide independent predictive information, the laboratory 
at least annually compares its patient results with published benchmarks, and 
evaluates interobserver variability among the pathologists in the laboratory.
NOTE: Individuals interpreting the assay must also have their concordance 
compared with each other and this concordance should also be at least 95%.
With specific reference to estrogen and progesterone receptor studies: in 
general, the overall proportion of ER-negative breast cancers (invasive and 
DCIS) should not exceed 30%. The proportion is somewhat lower in postmenopausal 
than premenopausal women (approximately 20% vs. 35%). The proportion is 
considerably lower in well-differentiated carcinomas (<10%) and certain special 
types of invasive carcinomas (<10% in lobular, tubular, and mucinous types).
The proportion of PgR-negative cases is 10-15% higher than for ER-negative in 
each of these settings. Investigation is warranted if the proportion of 
negative cases is significantly lower in any of these settings.

Joanne Clark, HT
Director of Histology
Pathology Consultants of New Mexico
Roswell, New Mexico




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