Comprehensive Histopathological Examination and Breast Cancer
An Institutional Analysis
Keywords:
Carcinoma breast, Gross examination, Extranodal extension, lymphovascular invasion
Abstract
Background: The histological patterns and other microscopic parameters play important role in the therapeutic management and assessment of the prognosis of the carcinoma breast. As this carcinoma shows heterogeneity, a careful gross examination followed by a more detailed examination of tissue sections is the backbone of the histopathological analysis. Methods: Total of 103 cases of breast carcinoma were included in the study. Histopathological reports along with detailed gross examination findings were re-assessed for various histological patterns and associated features. Data obtained was analysed. Result: Gross examination findings showed 9.4% multiplicentricity of the tumor. Histopathology revealed infiltrating ductal cell carcinoma not otherwise specified (IDC NOS) as most common histologic type (77.6%), I as common grade (45.8%) and IIA as common stage (28%) with other unique microscopic characteristics. Conclusion: Gross findings were more or less similar with results shown in the literatures except 9.4% multiple invasive pattern of the tumor. Different histopathological findings were papillary carcinoma as second common histogical pattern, histologic grade I as common grade, evidence of lymphovascular invasion less common than perineural invasion. In addition atypical ductal hyperplasia was seen associated with papillary carcinoma commonly and desmoplasia with N0 tumor.References
1. Makki J. Diversity of breast carcinoma: Histological subtypes and clinical relevance. Clin Med insights Pathol. 2015;8:23-31.
2. Wilson E, Feakins R. The use of a standard proforma in breast cancer reporting. J Clin Pathol. 2002;55:718-20.
3. Salgado R, Denkert C, Demaria S, Sirtaine N, Klauschen F, Pruneri G, Wienert S et al. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol. 2015;26:259–71.
4. Bellolio JE, Guzman GP, Orellana CJ, Roa SJC, Villaseca HM, Araya O et al. Diagnostic value of frozen section biopsy during surgery for breast lesions or neoplasms. Rev Med Chil. 2009;137:1173-8.
5. Bell WC, Young ES, Billings PE, Grizzle WE. The efficient operation of the surgical pathology gross room. Biotechnic & histochemistry : official publication of the Biological Stain Commission. 2008;83:71-82.
6. Coomb NJ, Boyages J. Multifocal and multicentric breast tumour: does each focus matter? J Clin Oncol. 2005;23:7497-502.
7. Zhou M, Tang Zh, Li J, Fan JH, Pang Y, Yang H et al. Clinical and pathologic features of multifocal and multicentric breast cancer in Chinese women: A retrospective cohort study. J Breast Cancer. 2013;16:77-83.
8. Brierley JD, Gospodarowicz MK, Wittekind C, editors. The TNM classification of malignant tumours. 8. Oxfordth: Wiley-Blackwell; 2017.
9. Milulescu A, Di Marino L, Peradze N, Toesca A. Management of multifocal-multicentric breast cancer: Current perspective. Chirugia (Bucur). 2017;112:12-7.
10. Wang J, Xiao X, Wang J, Iqbal N, Baxter L, Skinner KA et al. Predictors of Nipple–Areolar Complex Involvement by Breast Carcinoma: Histopathologic Analysis of 787 Consecutive Therapeutic Mastectomy Specimens. Ann Surg Oncol. 2012;19:1174-80.
11. Chagpar AB, Scoggins CR, Martin RC 2nd, Sahoo S, Carlson DJ, Laidley Al et al. Factors determining adequacy of axillary node dissection in breast cancer patients. Breast J. 2007;13:233-7.
12. An assessment of the burden and care of cancer patients. New Delhi: Indian Council of Medical Research; 2001. National Cancer registry Program: Ten year consolidated report of the Hospital Based Cancer Registries, 1984-1993.
13. Nigam JS, Yadav P, Sood N. A retrospective study of clinico-pathological spectrum of carcinoma breast in a West Delhi, India. South Asian J Cancer. 2014;3:179-81.
14. Pradhan A, Paudyal P, Sinha AK, Agarwal CS. Grading, staging and Nottingham prognostic index scoring of breast carcinoma. Journal of Pathology of Nepal. 2017;7:1078-83.
15. Wani SQ, Khan T, Wani SY, Koka AH, Arshad S, Rafiq L, Mqabool LM, Afroz F. Clinicoepidemiological analysis of female breast cancer patients in Kashmir. J Cancer Res Ther. 2012;8:389-93.
16. Saxena S, Rekhi B, Bansal A, Bagga A, Chintamani, Murthy NS. Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India-A cross-sectional study. World J Surg Oncol. 2005;3:67.
17. Aziz S, Wik E, Knutsvik G, Klingen TA, Chen Y, Davidsen B et al. Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer. PloS ONE. 2017;12:e0171853.
18. Wu SG, Zhang WW, Sun JY, He ZY. Prognostic value of ductal carcinoma in situ component in invasive ductal carcinoma of the breast: a Surveillance, Epidemiology, and End Results database analysis. Cancer Manag. Res. 2018;10:527-34.
19. Wagoner ML, Laronga CH, Acs G. Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision. Am J Clin Pathol. 2009;131:112–21.
20. Shashikala R, Ravindra S. Proliferative fibrocystic lesions in association with carcinoma breast- Study of mastectomy specimens. International Journal of Biomedical and Advance Research. 2015;6:574-9.
21. DeClerck YA. Desmoplasia: A response or a Niche? Cancer Discov. 2012;3:143-45.
22. Rakha EA, Martin S, Lee AHS, Morgan D, Pharoah PDP, Hodi Z et al. The Prognostic Significance of Lymphovascular Invasion in Invasive Breast Carcinoma. Cancer 2012;118:3670-80.
23. Karak SG, Quatrano N, Buckley J, Ricci A. Prevalence and significance of perineural invasion in invasive breast carcinoma. Conn Med. 2010;74:17-21.
24. Barrio AV, Morrow M. Appropriate margin for lumpectomy excision of invasive breast cancer. Chin Clin Oncol. 2016;5:35.
25. Romagnoli G, Wiedermann M, Hübner F, wenners A, Mathiak M, Rocken CH. Morphological evaluation of tumor-infiltrating lymphocytes (TILs) to investigate invasive breast cancer immunogenicity, reveal lymphocytic networks and help relapse prediction: A retrospective study. Int. J. Mol. Sci. 2017;18:1936.
2. Wilson E, Feakins R. The use of a standard proforma in breast cancer reporting. J Clin Pathol. 2002;55:718-20.
3. Salgado R, Denkert C, Demaria S, Sirtaine N, Klauschen F, Pruneri G, Wienert S et al. The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol. 2015;26:259–71.
4. Bellolio JE, Guzman GP, Orellana CJ, Roa SJC, Villaseca HM, Araya O et al. Diagnostic value of frozen section biopsy during surgery for breast lesions or neoplasms. Rev Med Chil. 2009;137:1173-8.
5. Bell WC, Young ES, Billings PE, Grizzle WE. The efficient operation of the surgical pathology gross room. Biotechnic & histochemistry : official publication of the Biological Stain Commission. 2008;83:71-82.
6. Coomb NJ, Boyages J. Multifocal and multicentric breast tumour: does each focus matter? J Clin Oncol. 2005;23:7497-502.
7. Zhou M, Tang Zh, Li J, Fan JH, Pang Y, Yang H et al. Clinical and pathologic features of multifocal and multicentric breast cancer in Chinese women: A retrospective cohort study. J Breast Cancer. 2013;16:77-83.
8. Brierley JD, Gospodarowicz MK, Wittekind C, editors. The TNM classification of malignant tumours. 8. Oxfordth: Wiley-Blackwell; 2017.
9. Milulescu A, Di Marino L, Peradze N, Toesca A. Management of multifocal-multicentric breast cancer: Current perspective. Chirugia (Bucur). 2017;112:12-7.
10. Wang J, Xiao X, Wang J, Iqbal N, Baxter L, Skinner KA et al. Predictors of Nipple–Areolar Complex Involvement by Breast Carcinoma: Histopathologic Analysis of 787 Consecutive Therapeutic Mastectomy Specimens. Ann Surg Oncol. 2012;19:1174-80.
11. Chagpar AB, Scoggins CR, Martin RC 2nd, Sahoo S, Carlson DJ, Laidley Al et al. Factors determining adequacy of axillary node dissection in breast cancer patients. Breast J. 2007;13:233-7.
12. An assessment of the burden and care of cancer patients. New Delhi: Indian Council of Medical Research; 2001. National Cancer registry Program: Ten year consolidated report of the Hospital Based Cancer Registries, 1984-1993.
13. Nigam JS, Yadav P, Sood N. A retrospective study of clinico-pathological spectrum of carcinoma breast in a West Delhi, India. South Asian J Cancer. 2014;3:179-81.
14. Pradhan A, Paudyal P, Sinha AK, Agarwal CS. Grading, staging and Nottingham prognostic index scoring of breast carcinoma. Journal of Pathology of Nepal. 2017;7:1078-83.
15. Wani SQ, Khan T, Wani SY, Koka AH, Arshad S, Rafiq L, Mqabool LM, Afroz F. Clinicoepidemiological analysis of female breast cancer patients in Kashmir. J Cancer Res Ther. 2012;8:389-93.
16. Saxena S, Rekhi B, Bansal A, Bagga A, Chintamani, Murthy NS. Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India-A cross-sectional study. World J Surg Oncol. 2005;3:67.
17. Aziz S, Wik E, Knutsvik G, Klingen TA, Chen Y, Davidsen B et al. Extra-nodal extension is a significant prognostic factor in lymph node positive breast cancer. PloS ONE. 2017;12:e0171853.
18. Wu SG, Zhang WW, Sun JY, He ZY. Prognostic value of ductal carcinoma in situ component in invasive ductal carcinoma of the breast: a Surveillance, Epidemiology, and End Results database analysis. Cancer Manag. Res. 2018;10:527-34.
19. Wagoner ML, Laronga CH, Acs G. Extent and histologic pattern of atypical ductal hyperplasia present on core needle biopsy specimens of the breast can predict ductal carcinoma in situ in subsequent excision. Am J Clin Pathol. 2009;131:112–21.
20. Shashikala R, Ravindra S. Proliferative fibrocystic lesions in association with carcinoma breast- Study of mastectomy specimens. International Journal of Biomedical and Advance Research. 2015;6:574-9.
21. DeClerck YA. Desmoplasia: A response or a Niche? Cancer Discov. 2012;3:143-45.
22. Rakha EA, Martin S, Lee AHS, Morgan D, Pharoah PDP, Hodi Z et al. The Prognostic Significance of Lymphovascular Invasion in Invasive Breast Carcinoma. Cancer 2012;118:3670-80.
23. Karak SG, Quatrano N, Buckley J, Ricci A. Prevalence and significance of perineural invasion in invasive breast carcinoma. Conn Med. 2010;74:17-21.
24. Barrio AV, Morrow M. Appropriate margin for lumpectomy excision of invasive breast cancer. Chin Clin Oncol. 2016;5:35.
25. Romagnoli G, Wiedermann M, Hübner F, wenners A, Mathiak M, Rocken CH. Morphological evaluation of tumor-infiltrating lymphocytes (TILs) to investigate invasive breast cancer immunogenicity, reveal lymphocytic networks and help relapse prediction: A retrospective study. Int. J. Mol. Sci. 2017;18:1936.
Published
2020-01-29
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