Variability in the diagnosis and reporting of metaplastic breast carcinoma: results of an international survey.

IF 3.9 2区 医学 Q2 CELL BIOLOGY Histopathology Pub Date : 2024-12-04 DOI:10.1111/his.15381
Ellen Yang, Susan Fineberg, Anas Mohamed, Edi Brogi, Hannah Wen
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Abstract

Aims: Metaplastic breast carcinoma (MBC) is a heterogeneous group of invasive breast carcinoma with squamous, spindle cell, or mesenchymal elements. It may be monophasic or biphasic, and often coexists with invasive breast carcinoma of no special type (IBC-NST). Currently, there are no standardized guidelines for reporting MBC, and a diagnostic threshold for the metaplastic component is not established by the WHO classification.

Methods and results: A survey conducted from April-July 2023 gathered responses from 44 pathologists worldwide. Most respondents were academic breast pathologists, and attended weekly breast tumour boards. The criteria for diagnosing MBC were highly varied, with cutoffs ranging from any/<10% to >90% metaplastic component. Although 90% was the most common threshold used, only 25% of respondents applied it. Pathologists generally preferred diagnosing invasive carcinoma with mixed features when the metaplastic component was ≤50% and MBC when the metaplastic component >50%. Most pathologists reported both the type and percentage of metaplastic component. In all, 43% reported core biopsy and resection specimen with different approaches. Diagnostic guidelines reportedly used (if any) were highly varied.

Conclusion: The study underscores the need for standardized guidelines for MBC. Without clear and established diagnostic criteria, current data on MBC remains inconsistent and hinders further research into the clinical significance and prognostic implications of the metaplastic component.

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化生性乳腺癌的诊断和报告的可变性:一项国际调查的结果。
目的:化生性乳腺癌(MBC)是一种异质性的浸润性乳腺癌,具有鳞状、梭形细胞或间质成分。可为单相或双相,常与无特殊类型的浸润性乳腺癌(IBC-NST)共存。目前,没有报告MBC的标准化指南,世界卫生组织分类也没有确定化生成分的诊断阈值。方法和结果:一项调查于2023年4月至7月进行,收集了全球44名病理学家的回复。大多数受访者是学术乳腺病理学家,每周参加乳腺肿瘤委员会。诊断MBC的标准变化很大,临界值从任何/90%的化生成分不等。虽然90%是最常用的阈值,但只有25%的受访者使用它。当化生成分≤50%时,病理学家一般倾向于诊断混合性浸润性癌,当化生成分>50%时,病理学家通常倾向于诊断MBC。大多数病理学家报告了化生成分的类型和百分比。总的来说,43%的患者报告了不同入路的核心活检和切除标本。据报道,使用的诊断指南(如果有的话)差异很大。结论:本研究强调了制定MBC标准化指南的必要性。由于没有明确和确定的诊断标准,目前关于MBC的数据仍然不一致,这阻碍了对化生成分的临床意义和预后意义的进一步研究。
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来源期刊
Histopathology
Histopathology 医学-病理学
CiteScore
10.20
自引率
4.70%
发文量
239
审稿时长
1 months
期刊介绍: Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.
期刊最新文献
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