Sign-Out Tools: Breast

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Coded Comments

Code Comment
IDC Invasive ductal carcinoma
ILC Invasive lobular carcinoma
DCIS Ductal carcinoma in‐situ
DCIS1 Ductal carcinoma in‐situ, grade 1
DCIS2 Ductal carcinoma in‐situ, grade 2
DCIS3 Ductal carcinoma in‐situ, grade 2
ADH Atypical ductal hyperplasia
FEA Flat epithelial atypia
LCIS Lobular neoplasia (lobular carcinoma in‐situ)
ALH Lobular neoplasia (atypical lobular hyperplasia)
FBA Fibroadenoma
PASH Pseudoangiomatous stromal hyperplasia
FCC Fibrocystic changes
UDH Usual ductal hyperplasia
SCA Sclerosing adenosis
BDA Blunt duct adenosis
RADS Radial scar
HBX Healing biopsy site
XRT Changes consistent with prior irradiation
CALC Calcifications
CALC Calcifications
ITC Isolated tumor cells
KER1 Immunostained slides for cytokeratin AE1.3/Cam5.2, cytokeratin 7, and cytokeratin MNF116 were

examined on tissue levels.

KER2 Immunostained slides for cytokeratin AE1.3/Cam5.2, cytokeratin 7, and cytokeratin MNF116 were

examined on tissue levels from each of 2 blocks.

KER3 Immunostained slides for cytokeratin AE1.3/Cam5.2, cytokeratin 7, and cytokeratin MNF116 were

examined on tissue levels from each of 3 blocks.

GRDNR The tumor grade in this limited sample may not be representative of the entire lesion.
BRADS The results of immunohistochemical staining for estrogen receptor, progesterone receptor, and

Her2/neu protein expression and of fluorescence in‐situ hybridization studies for Her2/neu gene amplification will be reported in an addendum.

ERPR Note: The results of immunohistochemical staining for estrogen and progesterone receptors will

be reported in an addendum.

MARG NOTE: The resection margins of the specimen(s) were inked and microscopically evaluated; see

individual gross descriptions.

MARG1 NOTE: The resection margins of the specimen were inked and microscopically evaluated.
MARG2 NOTE: The resection margins of the specimens were inked and microscopically evaluated.
MULTI The patient’s chart and available radiographs were reviewed at the MGH Breast Center

multidisciplinary conference.

EEEEE This case does not contain all the coding components for CMS PQRI measure #99.

Grading Chart: Ductal Carcinoma In-situ Grading

Pleomorphic nuclei
Abundant central necrosis Present Absent
Present Grade 3 Grade 2
Absent Grade 3 Grade 1

[1]

Rauramo et al.: The effect of castration and peroral estrogen therapy on some psychological functions. Front Horm Res 1975;3:94-104. PMID: 1234567


Grading Chart: Invasive Carcinoma Grading

Score Tubule Formation Nuclear Pleomorphism Mitotic Count*
1 More than 75 % Slight 0 - 8
2 10% - 75% Moderate 9 - 17
3 Less than 10% Marked 18 or greater

* per 10 high power field with 40X objective and 10X ocular with a Field Diameter = 0.55 mm. A field diameter of 0.55 mm is assumed for this table and is compatable with sign-out booth Olympus microscopes. Please confirm that the field diameter of your microscope is 0.55 mm before using the above chart. For other field diameters, please see the conversion chart below.

Total Score Interpretation
3-5 Grade 1 (Low Grade)
6-7 Grade 2 (Intermediate Grade)
8-9 Grade 3 (High Grade)

[2]

Score Categories According to Field Diameter and Mitotic Count

Table of mitosis score thresholds by Field Diameter (mm)
Field Diameter (mm) Field Area (mm2 Number of Mitoses per 10 Fields
Score 1 Score 2 Score 3
0.50 0.196 ≤7 8 to 14 ≥15
0.51 0.204 ≤7 8 to 14 ≥15
0.52 0.212 ≤7 8 to 15 ≥16
0.53 0.221 ≤8 9 to 16 ≥17
0.54 0.229 ≤8 9 to 16 ≥17
0.55 0.238 ≤8 9 to 17 ≥18
0.56 0.246 ≤8 9 to 17 ≥18
0.57 0.255 ≤9 10 to 18 ≥19
0.58 0.264 ≤9 10 to 19 ≥20
0.59 0.273 ≤9 10 to 19 ≥20
0.60 0.283 ≤10 11 to 20 ≥21

References

  1. Jump up Citation: Silverstein et al.: Prognostic classification of breast ductal carcinoma-in-situ. Lancet 1995;345:1154-7. PMID: 7723550
    Abstract
  2. Jump up Citation: Robbins et al.: Histological grading of breast carcinomas: a study of interobserver agreement. Hum. Pathol. 1995;26:873-9. PMID: 7635449
    Abstract

Breast Service