cicaplab

Available online 14 May 2022

TaesungJeonMDHayeonKimMD, PhDAereeKimMD, PhDChungyeulKimMD, PhD

Abstract

Multifocal breast cancers are heterogeneous in terms of histologic characteristics and molecular types. In this study, we annotated multiple foci of invasive lesions and DCIS (ductal carcinoma in situ) lesions of 17 cases of multifocal breast cancer and investigated their immunohistochemical phenotypes (ER (estrogen receptor), PR (progesterone receptor), HER2 (human epidermal growth factor 2), Ki-67 proliferative index). Tumor histologic grade, proliferative index, and phenotypes were varied within each patient. We observed that there were some cases in which the treatment consideration could be changed due to different phenotypes of lesions. The proliferative index tended to be higher in areas where the histologic grade was higher. The TN (triple-negative) type had the highest Ki-67 index, followed by luminal B/HER2-, HER2, luminal B/HER2+, and luminal A types sequentially. As the luminal B lesions comprised a considerable portion of multifocal cancer, we subcategorized them according to several criteria. The proliferation index of the luminal B group was significantly (p < 0.001) higher in the low HR (hormone receptor) group than in the HR group. When compared by the phenotypes of the surrounding lesions, the proliferative index of luminal B lesions were intimately related to the coexisting phenotypes. In conclusion, the immunohistochemical phenotypes of multifocal breast cancer are heterogeneous, and luminal B type is the commonest of the heterogeneous phenotypes.

Volume 117, November 2021, Pages 42-50

Sindhu Shetty MD, Omar Habeeb MD¹, Christine Rivera B.S., Caroline Astbury PhD, Christopher Przybycin MD, Amy S. Joehlin-Price MD

Received: 27 March 2021 / Revised: 16 August 2021 / Accepted: 26 August 2021

Nelleke P. M. Brouwer, A. C. Lord, M. Terlizzo, A. C. Bateman, N. P. West, R. Goldin, A. Martinez, N. A. C. S. Wong, M. Novelli, I. D. Nagtegaal & G. Brown 

Abstract

The focus on lymph node metastases (LNM) as the most important prognostic marker in colorectal cancer (CRC) has been challenged by the finding that other types of locoregional spread, including tumor deposits (TDs), extramural venous invasion (EMVI), and perineural invasion (PNI), also have significant impact. However, there are concerns about interobserver variation when differentiating between these features. Therefore, this study analyzed interobserver agreement between pathologists when assessing routine tumor nodules based on TNM 8. Electronic slides of 50 tumor nodules that were not treated with neoadjuvant therapy were reviewed by 8 gastrointestinal pathologists. They were asked to classify each nodule as TD, LNM, EMVI, or PNI, and to list which histological discriminatory features were present. There was overall agreement of 73.5% (κ 0.38, 95%-CI 0.33–0.43) if a nodal versus non-nodal classification was used, and 52.2% (κ 0.27, 95%-CI 0.23–0.31) if EMVI and PNI were classified separately. The interobserver agreement varied significantly between discriminatory features from κ 0.64 (95%-CI 0.58–0.70) for roundness to κ 0.26 (95%-CI 0.12–0.41) for a lone arteriole sign, and the presence of discriminatory features did not always correlate with the final classification. Since extranodal pathways of spread are prognostically relevant, classification of tumor nodules is important. There is currently no evidence for the prognostic relevance of the origin of TD, and although some histopathological characteristics showed good interobserver agreement, these are often non-specific. To optimize interobserver agreement, we recommend a binary classification of nodal versus extranodal tumor nodules which is based on prognostic evidence and yields good overall agreement.

Received 30 May 2021, Revised 22 July 2021, Accepted 12 August 2021, Available online 19 August 2021.

Nicole C.M.VisserMD, PhD^abAnneke A.M.van der WurffMD, PhD^cJoannaIntHoutPhD^dCasperReijnenMD, PhD^efParag D.DabirMD^agGilda G.SoltaniMD^aLuthy S.M.AlcalaMD^hDorryBollMD, PhDⁱCarolien M.BronkhorstMD^jPeterBultMD, PhD^aPeggy M.A.J.GeominiMD, PhD^kDennisvan HamontMD, PhD^lHilde A.D.M.van HerkMD^bIneke M.de KievitMD, PhD^mHuyNgoMDⁿBrenda M.PijlmanMD^oMarc P.M.L.SnijdersMD, PhD^fM. CarolineVosMD, PhD^pIris D.NagtegaalMD, PhD^aLeon F.A.G.MassugerMD, PhD^qJohanna M.A.PijnenborgMD, PhD^qJohanBultenMD, PhD^a