A1 Refereed original research article in a scientific journal
Results of a worldwide survey on the currently used histopathological diagnostic criteria for invasive lobular breast cancer
Authors: De Schepper Maxim, Vincent-Salomon Anne, Christgen Matthias, Van Baelen Karen, Richard François, Tsuda Hitoshi, Kurozumi Sasagu, Brito Maria Jose, Cserni Gabor, Schnitt Stuart, Larsimont Denis, Kulka Janina, Fernandez Pedro Luis, Rodriguez-Martinez Paula, Olivar Ana Aula, Melendez Cristina, Van Bockstal Mieke, Kovacs Aniko, Varga Zsuzsanna, Wesseling Jelle, Bhargava Rohit, Boström Pia, Franchet Camille, Zambuko Blessing, Matute Gustavo, Mueller Sophie, Berghian Anca, Rakha Emad, Van Diest Paul J, Oesterreich Steffi, Derksen Patrick WB, Floris Giuseppe, Desmedt Christine
Publisher: SPRINGERNATURE
Publication year: 2022
Journal: Modern Pathology
Journal name in source: MODERN PATHOLOGY
Journal acronym: MODERN PATHOL
Number of pages: 9
ISSN: 0893-3952
eISSN: 1530-0285
DOI: https://doi.org/10.1038/s41379-022-01135-2
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Partially Open Access publication channel
Web address : https://www.nature.com/articles/s41379-022-01135-2
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/176277037
Self-archived copy's licence: CC BY
Self-archived copy's version: Publisher`s PDF
Invasive lobular carcinoma (ILC) represents the second most common subtype of breast cancer (BC), accounting for up to 15% of all invasive BC. Loss of cell adhesion due to functional inactivation of E-cadherin is the hallmark of ILC. Although the current world health organization (WHO) classification for diagnosing ILC requires the recognition of the dispersed or linear non-cohesive growth pattern, it is not mandatory to demonstrate E-cadherin loss by immunohistochemistry (IHC). Recent results of central pathology review of two large randomized clinical trials have demonstrated relative overdiagnosis of ILC, as only similar to 60% of the locally diagnosed ILCs were confirmed by central pathology. To understand the possible underlying reasons of this discrepancy, we undertook a worldwide survey on the current practice of diagnosing BC as ILC. A survey was drafted by a panel of pathologists and researchers from the European lobular breast cancer consortium (ELBCC) using the online tool SurveyMonkey (R). Various parameters such as indications for IHC staining, IHC clones, and IHC staining procedures were questioned. Finally, systematic reporting of non-classical ILC variants were also interrogated. This survey was sent out to pathologists worldwide and circulated from December 14, 2020 until July, 1 2021. The results demonstrate that approximately half of the institutions use E-cadherin expression loss by IHC as an ancillary test to diagnose ILC and that there is a great variability in immunostaining protocols. This might cause different staining results and discordant interpretations. As ILC-specific therapeutic and diagnostic avenues are currently explored in the context of clinical trials, it is of importance to improve standardization of histopathologic diagnosis of ILC diagnosis.
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