This document proposes a standardized synthetic table for reporting pathology results from breast biopsies, especially for invasive carcinomas. The table would assess factors like biopsy size, length of invasive carcinoma focus, histological type, grade, biomarkers, and provide a conclusion on the representativeness and informativeness of the biopsy. It presents an example table and concludes that the tables can be helpful, especially for determining grade and biomarkers in small cancers from biopsies alone or assessing response to neoadjuvant chemotherapy in large cancers.

1. The Pathologist and the breast biopsy report :
what about a synthetic table for invasive carcinoma?
Dr Elisabeth Russ
SENOPATH75
115, Rue du Château
75014 Paris
France
elisabeth.russ16@gmail.com

2. Genesis of the synthetic
table
• 2011 : original idea to transpose the pathology report table for
prostate biopsy to breast biopsy, especially for invasive
carcinomas
• Aim : to standardize the pathology reports of breast biopsy

3. contributory et representative nature of the biopsy
• Question : is the breast biopsy good enough for evaluation?
• contributory :
• Biopsy’s size
• Lenght of the invasive carcinoma focus (which paraffin block is informative?)
• representative : comparison between the lenght of the focus of invasive
carcinoma on the biopsy and the tumor size
• Is it the right grade?
• Are Hormone Receptors, Ki67 and HER2 good evaluated on the biopsy?
• Allways add a conclusion.

4. The table report
how many biopsies how many blocks
Biopsies’ size (mm)
Invasive carcinoma’s lenght : largest focus (mm) Informative paraffin block
Histological type of invasive carcinoma
architecture Well, moderate ou no differenciated (score)
anisokaryosis Mild to marked (score)
mitosis Number of mitosis/mm2 (score)
TIL (tumor infiltrating lymphocytes) %
Estrogen Receptors % of tumor cells intensity
Progesterone Receptors % of tumor cells intensity
Ki67 % of tumor cells
HER2 % of tumor cells Intensity et quality of the membrane staining
In situ carcinoma % nuclear grade, architecture

5. The table report : an example
Nombre de biopsiesno 22 Nombre de blocs : 2
Biopsies’ size (mm) 15/12
Invasive carcinoma’s lenght :
Largest focus (mm)
7 informative block : A
Histological type non specific type (NST)
architecture Moderate differenciated (score 2)
Anisokaryosis Moderate (score 2)
mitosis 2/mm2 (score 1)
TIL 10%
Estrogen Receptors 100% of tumor’s cells Intensity 3
Progesterone Receptors 100% of tumor’s cells Intensity 3
Ki67 10% of tumor’s cells
HER2 30% of tumor’s cells Weak incomplete membrane staining
Contingent de carcinome in situ 20% Intermediate nuclear grade
Cribriform architecture no necrosis, nor calcification
biopsies 2 2 blocks

6. Conclusion’s example
CONCLUSION :
• Invasive ductal carcinoma, moderate differenciated, non specific
type (NST)
• Histopronostic Index (E.E.) : 1 (2,2,1)
• Mitotic Index : mild
• TIL = 10%
• Hormone Receptors : strong positivity,
• Ki67 low
• Her2 negative (1+)

7. Value of pathology report tables in small cancers
T1a - T1b
• only scar or small foci of residual tumor after breast biopsy on
lumpectomy
• Especially after macro-biopsy
• All the informations are available on the pathology report table
of breast biopsy

8. Value of pathology report tables in large cancers
T2 - T3
• Neo-adjuvant chemotherapy
• If pCR : no residual tumor left on lumpectomy
• Very large size of the invasive carcinoma on biopsy is
necessary
• Macro-biopsy sometimes necessary.

9. Conclusion
• Pathology report table for breast biopsy can be helpfull
• Especially in invasive carcinomas
• Is the breast biopsy satisfactory enough to determine
histological grade and biomarkers (hormone receptors, Ki67
and HER2)?
• Small cancers T1a/T1b : only scar or small foci of residual
tumor after breast biopsy
• Large cancers T2/T3 : neo-adjuvant chemotherapy