College of American Pathologists
| |INVASIVE BREAST CANCER |
| |WORK AID |
|Patient Name: |Hospital #: |Case/Accession #: |
|Diagnosis: | |
|Specimen Laterality: | Right | Left | Not specified |
|Procedure: | |
| Excision w/o wire-guided loc | Total mastectomy |
| Excision w/ wire-guided loc. | Other: _____________________ |
|Lymph Node Sampling: (required only when lymph nodes are present) |
| No lymph nodes | Axillary dissection |
| Sentinel lymph node(s) | Lymph node(s) present w/in breast |
| Other: ____________________________________________________ |
|Invasive Carcinoma | |
|Size: |________ mm Cannot be determined |
|Tumor Focality: (required only if more than 1 focus of invasive carcinoma is |
|present) |
| Single | Indeterminate |
| Multiple* # of foci _________ |*size of largest focus: _____________ |
|Extent of Tumor: (required only if structures are present and involved) |
| Skin invasion w/o ulceration | Skin ulceration| |
| Skin Satellite nodules | | |
| Pectoralis muscle invasion | Chest wall beyond pectoralis invasion |
| Nipple Paget disease | |
|In Situ Component: |
| None Present | |
| DCIS | |
|Histologic Type: | Ductal Lobular Only microinvasion present |
| |Mixed ductal and lobular |
| | |
| |Other (specify): ____________________________ |
|Histologic Grade (SBR/Nottingham): |
| Score 1 | Score 2 | Score 3 |
| Only microinvasion present |
|No residual invasive carcinoma after neoadjuvant therapy |
|Score cannot be determined |
|Glandular/Tubular Differentiation: |
| 1 (>75% tubules) | 2 (10 to 75% tubules) | 3 (1 mm but ≤5 mm in greatest dimension pT1b: Tumor >5 mm but ≤10 mm in greatest dimension pT1c: Tumor >10 mm but ≤20 mm in greatest dimension pT2: Tumor >20 mm but ≤50 mm in greatest dimension pT3: Tumor >50 mm in greatest dimension pT4: Tumor of any size with direct extension to the chest wall and/or to the skin (ulceration or skin nodules). Note: Invasion of the dermis alone does not qualify as pT4. pT4a: Extension to chest wall, not including only pectoralis muscle adherence/invasion pT4b: Ulceration and/or ipsilateral satellite nodules and/or edema (including peau d’orange) of the skin which do not meet the criteria for inflammatory carcinoma pT4c: Both T4a and T4b pT4d: Inflammatory carcinoma
Regional Lymph Nodes (pN)
pNX: Regional lymph nodes cannot be assessed (eg, previously removed, or not removed for pathologic study) pN0: No regional lymph node metastasis identified histologically pN0 (i-): No regional lymph node metastases histologically, negative IHC pN0 (i+): Malignant cells in regional lymph node(s) no greater than 0.2 mm and no more than 200 cells (detected by H&E or IHC including ITC) pN0 (mol-): No regional lymph node metastases histologically, negative molecular findings (reverse transcriptase polymerase chain reaction [RT-PCR]) pN0 (mol+): Positive molecular findings (RT-PCR), but no regional lymph node metastases detected by histology or IHC pN1mi: Micrometastases (greater than 0.2 mm and/or more than 200 cells, but none greater than 2.0 mm). pN1a: Metastases in 1 to 3 axillary lymph nodes, at least 1 metastasis greater than 2.0 mm pN2a: Metastases in 4 to 9 axillary lymph nodes (at least 1 tumor deposit greater than 2.0 mm) pN3a: Metastases in 10 or more axillary lymph nodes (at least 1 tumor deposit greater than 2.0 mm)
Distant Metastasis (M)
cM0(i+): No clinical or radiographic evidence of distant metastasis, but deposits of molecularly or microscopically detected tumor cells in circulating blood, bone marrow, or other nonregional nodal tissue that are ≤0.2 mm in a patient without symptoms or signs of metastasis pM1: Distant detectable metastasis as determined by classic clinical and radiographic means and/or histologically proven >0.2 mm
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