Template:Reporting of invasive breast cancer
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Contents
Report
Breast excision
- Tumor size, if not already given from gross report.[1] Give 3 dimensions or greatest dimension.[1]
- Histopathologic subtype if apparent, but "invasive carcinoma" is acceptable.
- Stage[1]
- Grade, preferably by overall BRE grade. Optionally, give scores for the components thereof.[1]
- Extent of any angiolymphatic invasion.[1]
- Margins of resection,[1] as closest distance from carcinoma to margin in mm or cm or "tumor on ink"/"carcinoma is present on margin". ((If applicable, also specify as "close margins" (no tumor on ink but <2 mm), or "negative margins" (≥2 mm).))[2]
- Results of any immunohistochemistry and other tests[1]
- HER2 as a score or status.
- Ki-67, preferably as labeling index
Example:
Breast excision with 70 x 55 x 18 mm ductal invasive breast cancer. Nottingham grade II. Estrogen receptor positive, progesterone receptor negative, HER2 receptor score 0, Ki-67 index 17%, T1b. Radically removed. |
Needle or core biopsy
- Histopathologic subtype if apparent, but "invasive carcinoma" is acceptable.
- Results of any immunohistochemistry and other tests, as per excision[1]
- Presence of absence of lymphatic and/or vascular invasion[1]
- Optionally: Provisional grading. Grading can alternatively be deferred to excision.[1]
- State if studies are deferred for a later excision sample[1]
For cancers, generally include a synoptic report, such as per College of American Pathologists (CAP) protocols at cap.org/protocols-and-guidelines.
- synoptic report example
- Tumor type: invasive ductal carcinoma with micropapillary pattern
- Tumor size: greatest microscopic measurement of invasive carcinoma in positive core(s)): 0.7 cm
- In-situ component: no
- Microscopic grading (Nottingham modification of the Bloom-Richardson system):
- Only applies to infiltrating ductal and lobular carcinoma:
- Tubule formation: Little or none (score =3)
- Nuclear pleomorphism: Marked variation in size, nucleoli, chromatin clumping, etc. (score =3)
- Mitotic count : Less than 6 mitoses per 10 hpf (score =1)
- Composite score: 7 points (applies to infiltrating ductal and lobular carcinoma only)
- Histologic grade: Grade II: 6-7 points
- Nuclear grade: grade 3
- Microcalcifications: Present in non-neoplastic tissue
- Lymphocytic host response: absent
- Necrosis: absent
- Blood vessel invasion: absent
- Lymphatic and/or vascular invasion: absent
- Skin involvement: not applicable
- Results of immunohistochemical stains for prognostic markers (as per original report):
- Estrogen Receptor (ER) Status: Positive (greater than 10% of cells demonstrate nuclear positivity)
- Percentage of Cells with Nuclear Positivity: 91-100%
- Average Intensity of Staining: Strong
- Progesterone Receptor (PgR) Status: Positive
- Percentage of Cells with Nuclear Positivity: 51-60%
- Average Intensity of Staining: Strong, moderate and weak
- Estrogen Receptor (ER) Status: Positive (greater than 10% of cells demonstrate nuclear positivity)
- HER-2 by IHC: 2+ / Equivocal
- REFLEX HER-2 FISH TEST: Nonamplificed (ratio 1.5; 3.5 Her-2 signals/cell)
- Ki-67:
- Percentage of Cells with Nuclear Positivity: 43%
- Primary Antibody: MIB1
- Cold Ischemia and Fixation Times: 3 minutes
- Fixation Time (hours): 14 hours and 33 minutes
- Fixative: formalin
Notes
Main page
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 . Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type). Stanford Medical School. Retrieved on 2019-10-02.
- ↑ 2.0 2.1 Bundred JR, Michael S, Stuart B, Cutress RI, Beckmann K, Holleczek B (2022). "Margin status and survival outcomes after breast cancer conservation surgery: prospectively registered systematic review and meta-analysis. ". BMJ 378: e070346. doi: . PMID 36130770. PMC: 9490551. Archived from the original. .
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