Atypia in breast pathology: what pathologists need to know

Katayama, Ayaka; Toss, Michael S.; Parkin, Matthew; Ellis, Ian O.; Quinn, Cecily; Rakha, Emad A.

doi:10.1016/j.pathol.2021.09.008

Cited by 12 publications

(15 citation statements)

References 49 publications

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“…Eine atypische duktale Hyperplasie (ADH; Abb. 1 ) ist definiert als eine klonale low-grade intraduktale Proliferation, die eine maximale Ausdehnung von 2 mm nicht überschreitet [ 16 , 40 , 47 , 55 ]. Häufig, aber nicht immer sind assoziierte Verkalkungen dabei bildgebend zu identifizieren [ 40 , 55 ].…”

Section: Atypische Duktale Hyperplasieunclassified

“…Ergänzende immunhistochemische Färbungen sind hilfreich für die Diagnosebestätigung. Eine ADH exprimiert stark und diffus Östrogenrezeptoren in 100 % der Zellkerne und zeigt dabei einen Verlust der basalen Zytokeratine (CK5/6 oder CK14) [ 16 , 40 , 41 , 47 ]. Die internationale übliche Bezeichnung, die auch in der WHO-Klassifikation geführt wird, ist die „ADH“ wobei in einigen europäischen Ländern auch der Begriff „AIDEP“ („atypical intraductal epithelial proliferation“) gebraucht wird.…”

Section: Atypische Duktale Hyperplasieunclassified

“…Innerhalb der B‑Klassifikation, die 5 Kategorien zur Einordnung der histologischen Veränderungen in diagnostischen Nadelbiopsien umfasst, stellen die B3-Läsionen der Mamma eine heterogene Gruppe von histologisch definierten Erkrankungen dar [ 1 , 16 , 21 , 40 , 47 ]. Entweder handelt es sich um Läsionen mit Risiko eines assoziierten duktalen Carcinoma in situ (DCIS) oder invasiven Karzinoms oder um Entitäten mit Risiko eines unvollständigen Samplings [ 1 , 40 , 46 , 55 ].…”

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“…Diese Entitäten zeigen zum Teil überlappende Eigenschaften sowohl morphologisch als auch radiologisch, was die nachfolgenden nächsten diagnostischen Schritte erschweren kann [ 1 , 16 , 40 , 46 , 47 , 55 ]. Den B3-Läsionen wird ein unsicheres biologisches Potenzial zugeordnet, weswegen eine interdisziplinäre Besprechung der jeweiligen Entitäten und eine regelmässige Anpassung der klinischen Empfehlungen zum therapeutischen Vorgehen in Abhängigkeit der aktuellen Datenlage erforderlich sind [ 1 , 40 ].…”

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B3-Läsionen der Mamma: Histologische, klinische und epidemiologische Aspekte

2023

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ZusammenfassungB3-Läsionen der Mamma stellen eine heterogene Gruppe von Läsionen mit unsicherem Malignitätspotenzial dar, welche histologisch klar definierte Diagnosen beinhalten und welche in diagnostischem und therapeutischem Kontext unterschiedlich gewichtet und behandelt werden. Vor allem die Entscheidung über die Schritte nach der Diagnose einer B3-Läsion an Stanzbiopsie oder Vakuumbiopsie können eine Herausforderung darstellen. B3-Läsionen werden oft wegen bildgebenden Kalzifikationen oder Herdbefunden entdeckt und biopsiert. Histologisch können die Veränderungen einer Reihe von häufigen Diagnosen (wie die atypische duktale Hyperplasie, die klassische lobuläre Neoplasie, flache Epithelatypien, intraduktale Papillome, radiäre Narben oder fibroepitheliale Tumoren vom Typ eines Phylloidestumors) oder seltenen Diagnosen (wie Mukozelen-ähnliche Läsion, atypische apokrine Läsionen und seltene stromale Proliferate) zugeordnet werden. Immunhistochemie ist hilfreich in der Differenzierung und einer korrekten nomenklatorischen Zuordnung dieser Läsionen (vor allem Östrogenrezeptoren, basale Zytokeratine, Myoepithelmarker oder stromale Markerpanel). Im klinischen Kontext bleibt die Korrelation der bildgebenden und histologischen Befunde der wichtigste Faktor in der Entscheidung der nächsten diagnostischen/therapeutischen Schritte.

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Section: Atypische Duktale Hyperplasieunclassified

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B3-Läsionen der Mamma: Histologische, klinische und epidemiologische Aspekte

2023

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“…Key points: Individual pathologists differ markedly in their approach to nuclear grading 14,15 Few cancers possess the very bland nuclei warranting an atypia/pleomorphism score of 1, and obvious atypia/pleomorphism should attract a score of 3. The minimum proportion of tumour nuclei that should show marked nuclear atypia/pleomorphism before a score of 3 is allocated has not been defined, but the finding of an occasional enlarged or bizarre nucleus should not be used to give a score of 3 rather than a score of 2. Features that can be used to assess atypia/pleomorphism include nuclear size, outlines, variation in the size and shapes, degree of nuclear chromasia, and nucleoli. Comparison with normal epithelial cell nuclei lining normal acini or ducts can help as control for nuclear size.…”

Section: Highlights Of the Invasive Breast Cancer Dataset With A Focu...mentioning

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An international unified approach to reporting and grading invasive breast cancer. An overview of the International Collaboration on Cancer Reporting (ICCR) initiative

et al. 2022

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Standardised reporting of breast cancer key pathology data has become the norm in some parts of the world, but are based on national or regional guidelines that differ in certain aspects, resulting in divergent reporting practices and a lack of comparability of data internationally. The International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter‐)national pathology and cancer organizations, have recently produced a new international dataset for the pathology reporting of breast cancer, including resection specimens with invasive cancer and ductal carcinoma in situ (DCIS) of the breast. This initiative aims at providing an international unified approach to reporting cancer. The guidance was prepared by an international expert panel consisting of experienced breast pathologists, a surgeon, and an oncologist. The dataset includes core (essential) and noncore (optional) data items based on a critical review and discussion of current evidence. Commentary is provided for each data item to explain the rationale for selection, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. The process concludes with international public consultation, before ratification and publication on the free open access ICCR website, with a synoptic reporting guide. The key aim is to promote high‐quality, standardised pathology reporting that can be used worldwide. Histological grade, tumour size, and oestrogen receptor status are used in this article to illustrate this process and the detail provided to support its inclusion.

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Deep learning application in prediction of cancer molecular alterations based on pathological images: a bibliographic analysis via CiteSpace

Xiaojian,

Zhanbo,

Jian

et al. 2024

J Cancer Res Clin Oncol

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Background The advancements in artificial intelligence (AI) technology for image recognition were propelling molecular pathology research into a new era. Objective To summarize the hot spots and research trends in the field of molecular pathology image recognition. Methods Relevant articles from January 1st, 2010, to August 25th, 2023, were retrieved from the Web of Science Core Collection. Subsequently, CiteSpace was employed for bibliometric and visual analysis, generating diverse network diagrams illustrating keywords, highly cited references, hot topics, and research trends. Results A total of 110 relevant articles were extracted from a pool of 10,205 articles. The overall publication count exhibited a rising trend each year. The leading contributors in terms of institutions, countries, and authors were Maastricht University (11 articles), the United States (38 articles), and Kather Jacob Nicholas (9 articles), respectively. Half of the top ten research institutions, based on publication volume, were affiliated with Germany. The most frequently cited article was authored by Nicolas Coudray et al. accumulating 703 citations. The keyword "Deep learning" had the highest frequency in 2019. Notably, the highlighted keywords from 2022 to 2023 included “microsatellite instability”, and there were 21 articles focusing on utilizing algorithms to recognize microsatellite instability (MSI) in colorectal cancer (CRC) pathological images. Conclusion The use of DL is expected to provide a new strategy to effectively solve the current problem of time-consuming and expensive molecular pathology detection. Therefore, further research is needed to address issues, such as data quality and standardization, model interpretability, and resource and infrastructure requirements. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s00432-024-05992-z.

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Atypia in breast pathology: what pathologists need to know

Cited by 12 publications

References 49 publications

B3-Läsionen der Mamma: Histologische, klinische und epidemiologische Aspekte

B3-Läsionen der Mamma: Histologische, klinische und epidemiologische Aspekte

An international unified approach to reporting and grading invasive breast cancer. An overview of the International Collaboration on Cancer Reporting (ICCR) initiative

Deep learning application in prediction of cancer molecular alterations based on pathological images: a bibliographic analysis via CiteSpace

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