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Invasive Carcinoma With Chemotherapy Carcinoma
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Invasive Carcinoma With Chemotherapy Carcinoma
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Breast Invasive Carcinoma with Neoadjuvant Chemotherapy
- Any complete excision (i.e. lumpectomy, partial mastectomy) or mastectomy with invasive carcinoma, including DCIS with microinvasion, following neoadjuvant chemotherapy
Specimen and Surgical Procedure
Specimen, laterality, procedure.......................................................
Lymph nodes submitted and/or identified in the specimen................... yes/no
If present, specify type(s) of lymph nodes..............................
Invasive Carcinoma
Tumor focality........................................................................ unifocal/multifocal
Tumor bed identified..................................................................... yes/no
Size of tumor bed.........................................................................
Tumor size* (size of residual invasive carcinoma)............................. __ mm
* report "microinvasion only" if ≤ 1 mm; state “no residual invasive carcinoma,” if
applicable
Overall residual viable carcinoma cellularity within the tumor bed........ %
Histologic type.............................................................................
Histologic grade (do not grade microinvasion)
Tubular Differentiation Score (Select Option Below)………………………………….
___ Score 1 (>75% of tumor area forming glandular/tubular structures)
___ Score 2 (10% to 75% of tumor area forming glandular/tubular structures)
___ Score 3 (<10% of tumor area forming glandular/tubular structures)
___ Only microinvasion present (not graded)
___ No residual invasive carcinoma
___ Score cannot be determined
Nuclear Pleomorphism Score (Select Option Below)................................
___ Score 1 (nuclei small with little increase in size in comparison with normal breast epithelial cells, regular outlines, uniform nuclear chromatin, little variation in size)
___ Score 2 (cells larger than normal with open vesicular nuclei, visible nucleoli, and moderate variability in both size and shape)
___ Score 3 (vesicular nuclei, often with prominent nucleoli, exhibiting marked variation in size and shape, occasionally with very large and bizarre forms)
___ Only microinvasion present (not graded)
___ No residual invasive carcinoma
___ Score cannot be determined
Mitotic Rate Score(Select Option Below).........................................
___ Score 1 (≤3 mitoses per mm2) (see Table 1)
___ Score 2 (4-7 mitoses per mm2) (see Table 1)
___ Score 3 (≥8 mitoses per mm2) (see Table 1)
___ Only microinvasion present (not graded)
___ No residual invasive carcinoma
___ Score cannot be determined
Total Score (3-9)...............................................................
Overall Grade (1-3)................................................................
Lymphovascular invasion in breast tissue........................................ present/absent
Dermal lymphovascular invasion.................................................... present/absent
Tumor Extension (required only if structures are present)………………... Skin/Nipple/Skeletal Muscle/Not Applicable
DCIS
DCIS present............................................................................... yes/no
Optional features (most relevant in cases with extensive DCIS)
Extensive intraductal component (EIC) present...................... yes/no
Size/Extent of DCIS (greatest dimension and/or # of slides)....
Nuclear grade...................................................................
Necrosis........................................................................... present/absent
LCIS present (optional) ............................................................... yes/no
Final Margins
Closest Linear Extent Specimen
Location Distance (within 2 mm) Designation
Invasive (Mastectomy)
Deep
Base of nipple*
Other Surgical Surface
Anterosuperior
Anteroinferior
DCIS (Mastectomy)
Deep
Base of nipple*
Other Surgical Surface
Anterosuperior
Anteroinferior
Invasive (Lumpectomy)
Superficial
Deep
Medial
Lateral
Superior
Inferior
DCIS (Lumpectomy)
Superficial
Deep
Medial
Lateral
Superior
Inferior
*applicable to nipple-sparing mastectomies only
Lymph Nodes (section required ONLY if LNs present in the specimen)
Total number of lymph nodes examined (sentinel and non-sentinel)............................
Number of sentinel lymph nodes examined..............................................................
Lymph node involvement (required only if one or more lymph nodes have
tumor cells identified) ................................................................. present/absent
Number of lymph nodes with macrometastases (>2 mm)..........................................
Number of lymph nodes with micrometastases (>0.2 mm to 2 mm and/or >200 cells)...
Number of lymph nodes with isolated tumor cells (≤0.2 mm and ≤200 cells)................
Size of largest metastatic deposit (in mm) ................................................. ___ mm
Extranodal extension ........................................................................ present/absent
Ancillary Studies (MOL-__-_____)..................................................... yes/pending
Estrogen Receptor.................................................................... positive/negative
___% nuclear staining/___intensity
Progesterone Receptor.............................................................. positive/negative
___% nuclear staining/___intensity
HER2
Immunohistochemistry...................................... positive/equivocal/negative
FISH............................................................. amplified/equivocal/negative
Is repeat testing ordered/needed* ...................................................... yes/no
(If yes, specify test ordered and block used)
Pathologic stage (AJCC 8th Ed.)....................................................... pT__N__M__