Template:Mitotic count in invasive breast cancer

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Author:

Mikael Häggström [note 1]

Mitosis appearances in breast cancer

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Mitotic figures are counted only at the periphery of the tumor, and counting should begin in the most mitotically active areas, and in at least 10 high-power fields (HPFs). If you know that the area of your high power field is about 0.2mm2, then you may score mitotic count as follows:[1]

  • 1 point: ≤7 mitoses per 10 HPFs
  • 2 points: 8 to 14 mitoses per 10 HPFs
  • 3 points: ≥15 mitoses per 10 HPFs

If you have a significant different HPF area or you are not sure, count 10 HPFs and calculate the number of mitoses per mm2 (Further information: Evaluation#Counts per mm2 ):

  • 1 point: ≤3 mitoses per mm2
  • 2 points: 4 to 7 mitoses per mm2
  • 3 points: ≥7 mitoses per mm2

A table of counts for various HPF sizes is available in notes below.[note 2]

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. ↑
    Table 1. Score categories according to field diameter and mitotic count
    Field diameter (mm) Area (mm²) Number of mitoses per 10 fields corresponding to:
    Score 1 Score 2 Score 3
    0.40 0.125 ≤4 5 to 9 ≥10
    0.41 0.132 ≤4 5 to 9 ≥10
    0.42 0.139 ≤5 6 to 10 ≥11
    0.43 0.145 ≤5 6 to 10 ≥11
    0.44 0.152 ≤5 6 to 11 ≥12
    0.45 0.159 ≤5 6 to 11 ≥12
    0.46 0.166 ≤6 7 to 12 ≥13
    0.47 0.173 ≤6 7 to 12 ≥13
    0.48 0.181 ≤6 7 to 13 ≥14
    0.49 0.189 ≤6 7 to 13 ≥14
    0.50 0.196 ≤7 8 to 14 ≥15
    0.51 0.204 ≤7 8 to 14 ≥15
    0.52 0.212 ≤7 8 to 15 ≥16
    0.53 0.221 ≤8 9 to 16 ≥17
    0.54 0.229 ≤8 9 to 16 ≥17
    0.55 0.238 ≤8 9 to 17 ≥18
    0.56 0.246 ≤8 9 to 17 ≥18
    0.57 0.255 ≤9 10 to 18 ≥19
    0.58 0.264 ≤9 10 to 19 ≥20
    0.59 0.273 ≤9 10 to 19 ≥20
    0.60 0.283 ≤10 11 to 20 ≥21
    0.61 0.292 ≤10 11 to 21 ≥22
    0.62 0.302 ≤11 12 to 22 ≥23
    0.63 0.312 ≤11 12 to 22 ≥23
    0.64 0.322 ≤11 12 to 23 ≥24
    0.65 0.332 ≤12 13 to 24 ≥25
    0.66 0.342 ≤12 13 to 24 ≥25
    0.67 0.353 ≤12 13 to 25 ≥26
    0.68 0.363 ≤13 14 to 26 ≥27
    0.69 0.374 ≤13 14 to 27 ≥28

    From: College of American Pathologists. [1] (Page 8), in turn citing: Pathology Reporting of Breast Disease, by National Health Service Cancer Screening Programme and The Royal College of Pathologists

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References

  1. ↑ . Protocol for the Examination of Resection Specimens from Patients with Invasive Carcinoma of the Breast Version: 4.7.0.1 - Table 1. Score Categories According to Field Diameter and Mitotic Count. College of American Pathologists. Protocol Posting Date: September 2022

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