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Consistency in recognizing microinvasion in breast carcinomas is improved by immunohistochemistry for myoepithelial markers
G. Cserni, CA. Wells, H. Kaya, P. Regitnig, A. Sapino, G. Floris, T. Decker, MP. Foschini, PJ. van Diest, D. Grabau, A. Reiner, J. DeGaetano, E. Chmielik, A. Cordoba, X. Andreu, V. Zolota, E. Charafe-Jauffret, A. Ryska, Z. Varga, N. Weingertner,...
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
NLK
ProQuest Central
od 2003-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2011-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2003-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2003-01-01 do Před 1 rokem
- MeSH
- imunohistochemie metody MeSH
- karcinom patologie MeSH
- laboratorní medicína metody normy MeSH
- lidé MeSH
- metastázy nádorů diagnóza MeSH
- nádorové biomarkery analýza MeSH
- nádory prsu patologie MeSH
- odchylka pozorovatele MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Microinvasion is the smallest morphologically identifiable stage of invasion. Its presence and distinction from in situ carcinoma may have therapeutic implications, and clinical staging also requires the recognition of this phenomenon. Microinvasion is established on the basis of several morphological criteria, which may be difficult and not perfectly reproducible among pathologists. The aim of this study was to assess the consistency of diagnosing microinvasion in the breast on traditional haematoxylin and eosin (HE) stained slides and to evaluate whether immunohistochemistry (IHC) for myoepithelial markers could improve this. Digital images were generated from representative areas of 50 cases stained with HE and IHC for myoepithelial markers. Cases were specifically selected from the spectrum of in situ to microinvasive cancers. Twenty-eight dedicated breast pathologists assessed these cases at different magnifications through a web-based platform in two rounds: first HE only and after a washout period by both HE and IHC. Consistency in the recognition of microinvasion significantly improved with the use of IHC. Concordance rates increased from 0.85 to 0.96, kappa from 0.5 to 0.85, the number of cases with 100% agreement rose from 9/50 to 25/50 with IHC and the certainty of diagnosis also increased. The use of IHC markedly improves the consistency of identifying microinvasion. This corroborates previous recommendations to use IHC for myoepithelial markers to clarify cases where uncertainty exists about the presence of microinvasion. Microinvasive carcinoma is a rare entity, and seeking a second opinion may avoid overdiagnosis.
2nd Department of Pathology Semmelweis University Budapest Üllői út 93 Budapest 1091 Hungary
CMP Cerba European Labs 45A avenue Wybran 1070 Brussels Belgium
Department of Histopathology St Vincent's University Hospital Dublin 4 Dublin Ireland
Department of Medical Sciences University of Torino Italy Via Santena 7 10120 Torino Italy
Department of Pathology Complejo Hospitalario de Navarra Irunlarrea 3 31008 Pamplona Navarra Spain
Department of Pathology Mater Dei Hospital Tal Qroqq Msida MSD 2090 Malta
Department of Pathology Medical School University of Patras 26504 Patras Rion Greece
Department of Pathology University Medical Center Utrecht Utrecht The Netherlands
Discipline of Pathology NUI Galway Clinical Sciences Institute Costello Road Galway Ireland
Institute of Pathology Breast Cancer Center Paderborn Husener Str 46a 33098 Paderborn Germany
Institute of Pathology Medical University Graz Auenbruggerplatz 25 8036 Graz Austria
Laboratório de Anatomia Patológica Centro Hospitalar de São João e IPATIMUP 4440 563 Porto Portugal
Pathologisch Bakteriologisches Institut Donauspital am SMZO Langobardenstraße 122 Vienna Austria
Pathology Centre Riga East Clinical University Hospital Hipokrata St 2 Riga LV 1038 Latvia
School of Medicine Department of Pathology Marmara University Istanbul Turkey
Citace poskytuje Crossref.org
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- $a Cserni, G $u Bács-Kiskun County Teaching Hospital, Nyiri ut 38, Kecskemét, 6000, Hungary. cserni@freemail.hu. Department of Pathology, University of Szeged, Allomás u. 2, Szeged, 6720, Hungary. cserni@freemail.hu.
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- $a Microinvasion is the smallest morphologically identifiable stage of invasion. Its presence and distinction from in situ carcinoma may have therapeutic implications, and clinical staging also requires the recognition of this phenomenon. Microinvasion is established on the basis of several morphological criteria, which may be difficult and not perfectly reproducible among pathologists. The aim of this study was to assess the consistency of diagnosing microinvasion in the breast on traditional haematoxylin and eosin (HE) stained slides and to evaluate whether immunohistochemistry (IHC) for myoepithelial markers could improve this. Digital images were generated from representative areas of 50 cases stained with HE and IHC for myoepithelial markers. Cases were specifically selected from the spectrum of in situ to microinvasive cancers. Twenty-eight dedicated breast pathologists assessed these cases at different magnifications through a web-based platform in two rounds: first HE only and after a washout period by both HE and IHC. Consistency in the recognition of microinvasion significantly improved with the use of IHC. Concordance rates increased from 0.85 to 0.96, kappa from 0.5 to 0.85, the number of cases with 100% agreement rose from 9/50 to 25/50 with IHC and the certainty of diagnosis also increased. The use of IHC markedly improves the consistency of identifying microinvasion. This corroborates previous recommendations to use IHC for myoepithelial markers to clarify cases where uncertainty exists about the presence of microinvasion. Microinvasive carcinoma is a rare entity, and seeking a second opinion may avoid overdiagnosis.
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