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. 2020 Mar;476(3):373-381.
doi: 10.1007/s00428-019-02641-6. Epub 2019 Aug 13.

The subgross morphology of breast carcinomas: a single-institution series of 2033 consecutive cases documented in large-format histology slides

Tibor Tot  1 , Maria Gere  2 , Syster Hofmeyer  2 , Annette Bauer  2 , Ulrika Pellas  2   3
Affiliations

The subgross morphology of breast carcinomas: a single-institution series of 2033 consecutive cases documented in large-format histology slides

Tibor Tot et al. Virchows Arch. 2020 Mar.

Abstract

A large-format histology technique represents the most convenient method for documenting and assessing the subgross morphological prognostic parameters of breast cancer (i.e., the distribution of the tumor's invasive and in situ components, disease extent, and tumor size), especially when used in conjunction with systematic radiological-pathological correlation. Here we report a consecutive series of 2033 breast carcinomas operated on in Dalarna, Sweden, with a particular focus on these subgross parameters. We separately analyzed the distributions of the in situ and invasive components of the tumors and then combined these into an aggregate pattern when both components were present. We found that 40% of breast carcinomas had a simple (unifocal) subgross morphology, while 60% had a complex morphology presenting with multifocal or diffuse components. Extensive tumors (occupying a total volume of breast tissue with the greatest dimension being ≥ 40 mm) were more common in complex cases, occurring in 66% of multifocal cases and 88% of diffuse cases, compared with only 5% of unifocal cases. Compared with luminal A-like tumors, HER2-expressing tumors exhibited a significantly larger extent. Triple-negative and basal-like carcinomas tended to have a larger tumor size (based on the largest dimension of the largest invasive focus). In this report, we discuss the prognostic impact of these parameters and the necessity of their correct assessment in the diagnostic routine.

Keywords: Diffuse breast cancer; Disease extent; Large-format histopathology; Multifocality.

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