A dedicated structured data set for reporting of invasive carcinoma of the breast in the setting of neoadjuvant therapy: recommendations from the International Collaboration on Cancer Reporting (ICCR)

• Published in: Histopathology Vol. 84; no. 7; pp. 1111 - 1129
• Main Authors: Bossuyt, Veerle, Provenzano, Elena, Symmans, W Fraser, Webster, Fleur, Allison, Kimberly H, Dang, Chau, Gobbi, Helenice, Kulka, Janina, Lakhani, Sunil R, Moriya, Takuya, Quinn, Cecily M, Sapino, Anna, Schnitt, Stuart, Sibbering, D Mark, Slodkowska, Elzbieta, Yang, Wentao, Tan, Puay Hoon, Ellis, Ian
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.06.2024
• Subjects: Breast cancer; Breast carcinoma; Cancer therapies; check‐list; Collaboration; Datasets; ICCR guidelines; invasive carcinoma of the breast; Invasiveness; Lymph nodes; Lymphatic system; Management decisions; neoadjuvant therapy; Pathology; protocol; structured report; synoptic report; Tumors; protocol; structured report; ICCR guidelines; check-list; data set; invasive carcinoma of the breast; synoptic report; neoadjuvant therapy
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/his.15165

Aims The International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter‐)national pathology and cancer organisations, is an initiative aimed at providing a unified international approach to reporting cancer. ICCR recently published new data sets for the reporting of invasive breast carcinoma, surgically removed lymph nodes for breast tumours and ductal carcinoma in situ, variants of lobular carcinoma in situ and low‐grade lesions. The data set in this paper addresses the neoadjuvant setting. The aim is to promote high‐quality, standardised reporting of tumour response and residual disease after neoadjuvant treatment that can be used for subsequent management decisions for each patient. Methods The ICCR convened expert panels of breast pathologists with a representative surgeon and oncologist to critically review and discuss current evidence. Feedback from the international public consultation was critical in the development of this data set. Results The expert panel concluded that a dedicated data set was required for reporting of breast specimens post‐neoadjuvant therapy with inclusion of data elements specific to the neoadjuvant setting as core or non‐core elements. This data set proposes a practical approach for handling and reporting breast resection specimens following neoadjuvant therapy. The comments for each data element clarify terminology, discuss available evidence and highlight areas with limited evidence that need further study. This data set overlaps with, and should be used in conjunction with, the data sets for the reporting of invasive breast carcinoma and surgically removed lymph nodes from patients with breast tumours, as appropriate. Key issues specific to the neoadjuvant setting are included in this paper. The entire data set is freely available on the ICCR website. Conclusions High‐quality, standardised reporting of tumour response and residual disease after neoadjuvant treatment are critical for subsequent management decisions for each patient. The first International Collaboration on Cancer Reporting (ICCR) data set for the pathology reporting of resection specimens with invasive carcinoma of the breast in the setting of neoadjuvant therapy aims to promote high‐quality, standardised pathology reporting across the globe. The widespread adoption of a dedicated structured reporting data set for the neoadjuvant setting will promote high‐quality, standardised reporting of tumour response and residual disease after neoadjuvant treatment that can be used for subsequent management decisions for each patient.