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BC Cancer Pathology Reviews

Updated March 2018

BC Cancer breast pathologists can be asked to review slides in the following situations:

  1. It is the suggestion of the BC Cancer Breast Tumour Group to consider a formal pathology review for node negative invasive breast cancers in which  a change in pathology could significantly change the prognosis of the  breast cancer and initiate a change in clinical management. 
  2. Cases in which clarification of specific aspects of the tumour would impact treatment decisions, e.g. margin size, can be reviewed prior to a final decision regarding treatment.  These reviews are typically requested as needed by a treating oncologist - radiation, medical, or surgical.

  1. Processing, Reporting and Special Histological Types including Prognostic Factors
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  3. Henson DE, et al. Practice protocol for the examination of specimens removed from patients with cancer of the breast (Cancer committee; College of American Pathologists) Arch Pathol Lab Med 1997;121:27-33.
  4. Nakhleh RE, et al. Mammographically directed breast biopsies: A College of American Pathologists Q-probe study of clinical physician expectations and of specimen handling and reporting characteristics in 434 institutions. Arch Pathol Lab Med 1997;121:11-18.
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  9. de Mascarel I, et al. Histological examination of 2859 breast biopsies: analysis of adequate sampling. Pathol Annual Pt 1; 1993;28:1-13.
  10. Owings DV, et al. How thoroughly should needle localisation breast biopsies be sampled for microscopic examination? A prospective mammographic/pathologic correlative study. Am J Surg Pathol 1990;14:578-588.
  11. Ellis IO, et al. Pathological prognostic factors in breast cancer. II. Histological type. Relationship with survival in a large study with long term follow-up. Histopathology 1992;20:479-489.
  12. 1Bloom HJG, Richardson WW. Histologic grading and prognosis in breast cancer: A study of 1709 cases of which 359 have been followed for 15 years. Br J Cancer 1957;2:353-377.
  13. Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 1991;19:403-410.
  14. Contesso G, et al. The importance of histological grade in long-term prognosis of breast cancer. A study of 1010 patients, uniformly treated at the Gustave-Roussy. J Clin Oncol 1987;5:1378-1386.
  15. Helpap B. Nuclear grading of breast cancer. Virchows Arch Path Anat 1989;415:501-508.
  16. Schnitt SJ, et al. Pathologic predictors of early local recurrence in stage I and stage II breast cancer treated by primary radiation therapy. Cancer 1984;53:1049-1057.
  17. Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. A Canadian Consensus Document. Canad. Med Assoc J 1998;158(3 Suppl):S1-83.
  18. Davis BW, et al. Prognostic significance of tumour grade in clinical trials of adjuvant therapy for breast cancer with axillary lymph node metastasis. Cancer 1986;58:2662-2670.
  19. Dalton LW, et al. Histological grading of breast cancer; a reproducibility study. Cancer 1994;73:2765-2770.
  20. Robbins P, et al. Histological grading of breast carcinomas. A study of inter-observer agreement. Hum Pathol 1995;8:873-879.
  21. Frierson HF, et al. Inter-observer reproducibility of the Nottingham modification of Bloom and Richardson histologic grading scheme for infiltrating ductal carcinoma. Am J Clin Pathol 1995;103:195-199.
  22. Galea MH, et al. The Nottingham Prognostic Index in primary breast cancer. Breast Cancer Res Treat 1992;3:207-219.
  23. Galea MH, Blamey RW, Elston CW, Ellis IO. The Nottingham Prognostic Index in primary breast cancer. Breast Cancer Res Treat 1992;3:207-219.
  24. Sundquist M, et al. Applying the Nottingham Prognostic Index to a Swedish breast cancer population. Breast Cancer Res Treat 1999;53:1-8.
  25. Stal O, et al. Significance of S-phase fraction and hormone receptor content in the management of young breast cancer patients. Br J Cancer 1992;66:706-711.
  26. Clark GM. Do we really need prognostic factors for breast cancer? Breast Cancer Res Treat 1994;30:117-126.
  27. Robertson JFR, et al. Biological factors of prognostic significance in locally advanced breast cancer. Breast Cancer Res Treat 1994;29:259-264.
  28. 2Cobleigh MA, et al. Efficacy and safety of Herceptin as a single agent in 22 women with Her2 overexpression who relapsed following chemotherapy for metastatic breast cancer. Proc Am Soc Clin Oncol 1998;17:97A (abstr 376).
  29. Remvikos Y, et al. Correlation of proliferative activity of breast cancer with response to cytotoxic therapy. J Nat Cancer Inst 1989;81:1383-1387.
  30. Resnick JM,et al. P53 and c-erbB-2 expression and response to preoperative chemotherapy in locally advanced breast carcinoma. Breast Dis. 1995;8:149-158.
  31. Muss HB, et al. C-erbB-2 expression and response to adjuvant therapy in women with node positive breast cancer. N Engl J Med 1994;330:1309-1310.
  32. Press MF, et al. HER-2/neu gene amplification characterised by fluorescence in-situ hybridization: Poor prognosis in node-negative breast carcinoma. J Clin Oncol 1997;15:2894-2904.
  33. Sjogren S, et al. Prognostic and predictive value of c-erbB-2 overexpression in primary breast cancer, alone and in combination with other prognostic markers. J Clin Oncol 1998;16:462-469.
  34. Baselga J, et al. Recombinant humanized anti-HER2 antibody (Herceptin) enhances the antitumor activity of paclitaxel and doxorubicin against HER2/neu overexpressing breast cancer xenografts. Cance Res. 1998;58:2825-2831.
  35. Pegram MD, et al. Phase II study of receptor-enhanced chemosensitivity using recombinant humanized anti-p185HER2/neu monoclonal antibody plus cisplatin in patients with HER2/neu-overexpressing metastatic breast cancer refractory to chemotherapy treatment. J Clin Oncol 1998;16:2659.
  36. Ross JS, Fletcher JA. The HER-2/neu oncogene: prognostic factor, predictive factor and target for therapy. Cancer Biology 19999;9:125-138.
  37. Pinder SE, et al. Pathological prognostic factors in breast cancer. III. Vascular invasion. Relationship with recurrence and survival in a large study with long-term follow-up. Histopathol 1994;24:41-47.
  38. 3Pereira H, et al. Pathological prognostic factors in breast cancer. IV. Should you be a typer or a grader? A comparative study of two histological prognostic features in operable breast carcinoma. Histopathol 1995;27:219-226.
  39. Diab SG, et al. Tumour characteristics and clinical outcome of tubular and mucinous breast carcinomas. J Clin Oncol 1999;17:1442-1448.
  40. Gasparini G, et al. Cell kinetics in human breast cancer: comparison between the prognostic value of cytofluorimetric S-phase fraction and that of the antibodies to Ki-67 and PCNA antigens detected by immunocytochemistry. Int J Cancer 1994;57:822-829.
  41. 4MacGrogan RP, et al. Prognostic significance of Ki-67 and topoisomerase II alpha expression in infiltrating ductal carcinoma of the breast. A multivariate analysis of 863 cases. Breast Cancer Res Treat 1999;55:61-71.
  42. Brown RW, et al. Prognostic value of Ki-67 compared to S-phase fraction in axillary node-negative breast cancer. Clin Cancer Res 1996;2:585-592.
  43. Gonzalez-Vela MC, et al. Predictors of axillary lymph node metastases in patients with invasive breast carcinoma by a combination of classical and biological prognostic factors. Pathol Res Pract 1999;195:611-618.
  44. Rudolph P, et al. Correlation between p53, c-erbB-2, and Topoisomerase II alpha expression, DNA ploidy, hormonal receptor status and proliferation in 356 node-negative breast carcinomas: prognostic implications. J Pathol 1999;187:207-216.
  45. Bozzetti C, et al. Bcl-2 expression on fine needle aspirates from primary breast carcinoma: correlation with other biologic factors. Cancer 1999;87:224-230.
  46. Holmqvist P, et al. Apoptosis and Bcl-2 expression in relation to age, tumour characteristics and prognosis in breast cancer. South-East Sweden Breast Cancer Group. Int J Biol Markers. 1999;14:84-91.
  47. Carey LA, et al. Telomerase activity and prognosis in primary breast cancers. J Clin Oncol 1999;17:3075-3081.
  48. Harbeck N, et al. Risk-group discrimination in node-negative breast cancer using invasion and proliferation markers: 6-year median follow-up. Brit J Cancer 1998;80:419-426 and Breast Cancer Res Treat 1999;54:147-157.
  49. Jahkola T, et al. Cathepsin D, urokinase plasminogen activator and type-1 plasminogen activator inhibitor in early breast cancer: an immunohistochemical study of prognostic value and relations to tenascin-C and other factors. Brit J Cancer 1999;80:167-174.
  50. Soler AP, et al. P-cadherin expression in breast carcinoma indicates poor survival. Cancer 19999;86:1263-1272.
  51. Tan DSP, et al. The biological and prognostic significance of cell polarity and E-cadherin in Grade I infiltrating ductal carcinoma of the breast. J Pathol 1999;189:20-27.
  52. Gonzalez MA, et al. An immunohistochemical examination of the expression of E-cadherin, alpha- and beta/gamma- catenins and alpha2- and beta1- integrins in invasive breast cancer. J Pathol 1999;187:523-529.
  53. Allred DC, et al. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 1998;11:155-168.
  54. Jager JJ, et al. Loco-regional recurrences after mastectomy in breast cancer: prognostic factors and implications for postoperative irradiation. Radiotherapy and Oncology 1999;50:267-275.

Lobular carcinoma

  1. Dixon JM, et al. Infiltrating lobular carcinoma of the breast. Histopathology 1982;6:149-161.
  2. DiCostanzo D et al. Prognosis of infiltrating lobular carcinoma. An analysis of "classical" and variant tumors. Am J Surg Pathol 1990;14:12-23.
  3. Fechner RE. Histological variants of infiltrating lobular carcinoma of the breast. Hum Pathol 1975;6:373-378.
  4. Fisher ER, et al. Tubulolobular invasive breast cancer: a variant of lobular invasive cancer. Hum Pathol 1977;8:679-683.
  5. Weidner N, Semple JP. Pleomorphic variant of invasive lobular carcinoma of the breast. Hum Pathol 1992;23:1167-1171.
  6. Eusebi V, et al. Pleomorphic lobular carcinoma of the breast: An aggressive tumour showing apocrine differentiation. Hum Pathol 1992;23:655-662.
  7. Frost AR. The significance of signet-ring cells in infiltrating lobular carcinoma of the breast. Arch Pathol Lab Med 1995;119:64-68.

DCIS Grading

  1. Schnitt SJ, et al. Developing a Prognostic index for ductal carcinoma in situ of the breast. Are we there yet? Cancer 1996;77:2189-2192.
  2. Silverstein MJ, et al. A prognostic index for ductal carcinoma in situ of the breast. Cancer 1996;77:2267-2274.
  3. Silverstein MJ, et al. Prognostic classification of breast ductal carcinoma in situ. Lancet 1995;345:1154-1157.
  4. Fisher ER, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) protocol B-17. Intraductal carcinoma (ductal carcinoma in situ). Cancer 1995;75:1310-1319.
  5. Holland R, et al. Microcalcification associated with ductal carcinoma in situ: mammographic-pathologic correlation. Semin Diagn Pathol 1994;11:181-192
  6. Holland R, et al. Ductal carcinoma in situ: a proposal for a new classification. Semin Diagn Pathol 1994;11:167-180.
  7. Leal CB, et al. Ductal carcinoma in situ of the breast; histological categorization and its relationship to ploidy, and immunohistochemical expression of hormone receptors, p54, and c-erbB-2 protein. Cancer 1995;75:2123-2131.
  8. Sneige N, et al. Ductal carcinoma in situ treated with lumpectomy and irradiation: histopathological analysis of 49 specimens with emphasis on risk factors and long term results. Hum Pathol 1995;26:642-649.
  9. Douglas-Jones AG, et al. A critical appraisal of six modern classifications od ductal carcinoma in situ of the breast (DCIS): correlation with grade of associated invasive carcinoma. Histopathology 1996;29:397-409.
  10. Consensus conference on the classification of ductal carcinoma in situ. Human Pathology 1997;28:1221-1225.

Estrogen Receptors

  1. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Modern Pathology 1998;11(2):155-168
  2. Leake R, et al. Immunohistochemical detection of steroid receptors in breast cancer: a working protocol. J Clin Pathol 2000;53:634-635
  3. Pertschuk LP, et al. Immunocytochemical estrogen and progestin receptor assays in breast cancer with monoclonal antibodies. Histopathologic, demographic and biochemical correlations and relationship to endocrine response and survival. Cancer 1990;66:1633-1670.
  4. Pertschuk LP, et al. Estrogen receptor immunocytochemistry in paraffin embedded tissues with ER1D5 predicts breast cancer endocrine response more accurately than H222Spgamma in frozen sections or cytosol-based ligand assays. Cancer 1996;77:2514-2519.
  5. Andersen J, et al. Immunohistochemical estrogen receptor determination in paraffin-embedded tissue. Prediction of response to hormone treatment in advanced breast cancer. Cancer 1989;64:1901-1908.
  6. Goulding H, et al. A new immunohistochemical antibody for the assessment of estrogen receptor status on routine formalin-fixed tissue samples. Human Pathol 1995;26:291-294.

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