Breast Invasive Carcinoma

- Any complete excision (i.e. lumpectomy, partial mastectomy) or mastectomy with invasive carcinoma, including DCIS with microinvasion

Specimen Identification

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 size (report "microinvasion only" if ≤ 1 mm).......................... __ mm

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__

Breast

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