Template:Reporting of invasive breast cancer
Revision as of 15:38, 4 March 2021 by Mikael Häggström (talk | contribs) (→Needle or core biopsy: Space)
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] either as minimal distance to margin, or as radical vs. not radical excision.
- 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 angiolymphatic invasion[1]
- Optionally: Provisional grading. Grading can alternatively be deferred to excision.[1]
- State if studies are deferred for a later excision sample[1]
- 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 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
- TUBULE FORMATION:
- NUCLEAR GRADE: Grade 3
- MICROCALCIFICATIONS: Absent
- LYMPHOCYTIC HOST RESPONSE: Absent
- NECROSIS: Absent
- BLOOD VESSEL INVASION: Absent
- LYMPHATIC PERMEATION: Indeterminate
- 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
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References
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