Breast Pathology, An Issue of Surgical Pathology Clinics

Cover image

Title page

Table of Contents

Copyright

Contributors

Forthcoming Issues

Preface

Error Reduction and Diagnostic Concordance in Breast Pathology

How to define error

Secondary review

Institutional review of outside cases

Breast-trained pathologists

Interdisciplinary approach

Practical/technical practices to reduce error

Leveraging ongoing assessment of error

Summary

Pathologic Evaluation of Lymph Nodes in Breast Cancer: Contemporary Approaches and Clinical Implications

Introduction

The evolution of axillary staging

Sentinel node surgical procedure

Contemporary intraoperative assessment of sentinel nodes

Permanent section pathologic evaluation of lymph nodes

The clinical impact of undetected metastases

Evaluation of sentinel lymph nodes following neoadjuvant chemotherapy

Incidental findings in breast axillary lymph nodes

Reporting lymph node findings

Clinics care points

Special Histologic Type and Rare Breast Tumors – Diagnostic Review and Clinico-Pathological Implications

Overview

Invasive lobular carcinoma

Clinics care points

Tubular carcinoma

Clinics care points

Invasive cribriform carcinoma

Mucinous carcinoma

Clinics care points

Mucinous cystadenocarcinoma

Clinics care points

Invasive micropapillary carcinoma

Clinics care points

Carcinoma with apocrine differentiation

Clinics care points

Metaplastic carcinoma

Clinics care points

Acinic cell carcinoma

Clinics care points

Adenoid cystic carcinoma

Clinics care points

Secretory carcinoma

Clinics care points

Mucoepidermoid carcinoma

Clinics care points

Polymorphous carcinoma

Clinics care points

Tall cell carcinoma with reversed polarity

Clinics care points

Neoadjuvant Therapy in Breast Cancer: Histologic Changes and Clinical Implications

Introduction

Prelude to neoadjuvant therapy

Approach to neoadjuvant therapy gross specimens

Approach to neoadjuvant therapy histologic sections

Localization and pathologic evaluation of sentinel lymph nodes

Approach to neoadjuvant therapy reporting

Intrinsic types, therapy response, and biomarkers after therapy

Pathologic response and tailored postsurgical therapy

Summary

Clinics care points

High-Grade Spindle Cell Lesions of the Breast: Key Pathologic and Clinical Updates

Overview

Malignant phyllodes tumor (MPT)

Spindle cell carcinoma (SpCC)

Matrix-producing metaplastic breast carcinoma (MP-MBC)

Primary breast sarcoma (PBS)

Metastases to the breast, including melanoma

Summary

Clinics care points

Atypical Ductal Hyperplasia-Ductal Carcinoma In Situ Spectrum: Diagnostic Considerations and Treatment Impact in the Era of Deescalation

Introduction

Natural history studies of atypical ductal hyperplasia and ductal carcinoma in situ

Complexities in the diagnosis of atypical ductal hyperplasia versus ductal carcinoma in situ

Clinical trials of active surveillance and risks of deescalation

Summary

A New Landscape of Testing and Therapeutics in Metastatic Breast Cancer

Overview

Hormone receptor and human epidermal growth factor receptor-2 testing

Programmed death-ligand 1 testing for immunotherapy

Mismatch repair protein deficiency, microsatellite instability, and tumor mutation burden testing

Single-gene alteration testing for targeted therapy

Future directions

Summary

The Critical Role of Breast Specimen Gross Evaluation for Optimal Personalized Cancer Care

Overview

Evaluation of breast specimens

Training in gross evaluation

Future directions in gross evaluation

Summary

Papillary Neoplasms of the Breast: Diagnostic Features and Molecular Insights

Overview

Intraductal papilloma (including papilloma with atypical ductal hyperplasia/ductal carcinoma in situ)

Papillary ductal carcinoma in situ

Solid papillary carcinoma

Encapsulated papillary carcinoma

Invasive papillary carcinoma

Adenomyoepithelioma

Risk-Associated Lesions of the Breast in Core Needle Biopsies: Current Approaches to Radiological-Pathological Correlation

Overview: breast core biopsy pathology and radiologic-pathologic correlation

Radiologic-pathologic correlation: definition

Key points

Radiologic-pathologic correlation for selected specific diagnoses

Key questions

Radiologic concordance and breast core biopsy pathology

Radiologic-pathologic correlation: lack of standardization

Key considerations

Radiologic-pathologic correlation: future directions

Clinics care points

Disclosure

Metaplastic Breast Carcinoma Revisited; Subtypes Determine Outcomes: Comprehensive Pathologic, Clinical, and Molecular Review

Overview

Pathology

Molecular alterations and target therapy

Tumor microenvironment and immunotherapy

Treatment

Prognosis

Clinics care points