Diagnostic interobserver variability of atypia assessment in columnar cell lesions among a group of expert breast pathologists in the United Kingdom and the Republic of Ireland, on behalf of the UK national coordinating committee for breast pathology.

Aims: Atypical ductal hyperplasia and flat epithelial atypia (FEA) have defined diagnostic criteria, yet there is variation in the interpretation of these criteria, particularly when the atypia is present in a background of columnar cell lesions (CCLs). This study focuses upon cases which are especially challenging or difficult to classify reproducibly according to existing criteria.

Methods And Results: Thirteen breast pathology experts were asked to classify 10 challenging cases with CLLs as atypical or non-atypical.

Computational Design of Pore-Forming Peptides with Potent Antimicrobial and Anticancer Activities.

Peptides that form transmembrane barrel-stave pores are potential alternative therapeutics for bacterial infections and cancer. However, their optimization for clinical translation is hampered by a lack of sequence-function understanding. Recently, we have designed the first synthetic barrel-stave pore-forming antimicrobial peptide with an identified function of all residues.

Challenges and Clinical Relevance of Modern Breast Pathology Reporting: Your Questions Answered.

Background: Breast pathology reporting, especially for breast cancer, has evolved through the years, from terse succinct diagnostic conclusions with scant histological details to the current comprehensive reporting guidelines issued by major pathology colleges and bodies, including the International Collaboration on Cancer Reporting. Pathology elements included in reporting guidelines are evidence based and contribute significantly to individualised and personalised patient management.

Summary: This article is based on the lively interactive question and answer session that followed the breast pathology segment in the symposium jointly organised by the British Association of Urological Pathology, British Association of Gynaecological Pathologists, British Society of Gastroenterology and the Association of Breast Pathology, in November 2022, titled "Personalised histopathology reporting for personalised medicine.

UK recommendations for HER2 assessment in breast cancer: an update.

The last UK breast cancer (BC) human epidermal growth factor receptor 2 (HER2) testing guideline recommendations were published in 2015. Since then, new data and therapeutic strategies have emerged. The American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) published a focused update in 2018 that reclassified in situ hybridisation (ISH) Group 2 (immunohistochemistry (IHC) score 2+and 2/chromosome enumeration probe 17 (17) ratio ≥2.

Reporting of Surgically Removed Lymph Nodes for Breast Tumors: Recommendations From the International Collaboration on Cancer Reporting.

Context.—: The International Collaboration on Cancer Reporting (ICCR), supported by major pathology and cancer organizations, aims at the standardization of evidence-based pathology reporting of different types of cancers, with the inclusion of all parameters deemed to be relevant for best patient care and future data collection. Lymph node metastasis is one of the most important prognostic factors in breast cancer.

Clinical utility of breast pathology data: implications for practising pathologists.

In breast cancer, the quality of the pathology services is of paramount importance as inevitably, the pathologist makes the confirmatory diagnosis and provides prognostic and predictive information, informing treatment plans directly. Various national and international organisations provide a pathology reporting minimum dataset (MDS) to ensure consistency in reporting. While the use of MDS promotes clarity, there may be specific areas requiring the pathologist's input for individual patients and hence pathologists need to be aware of the clinical utility of pathology data to help tailor individualised patient treatment.

Chemistry of the Bis(imine)-Based Tetradentate Ligand Stabilized Group 14 E(II) Cations (E=Ge and Sn).

The ambiphilic Ge(II) and Sn(II) cationic species have been reported to be isolated through kinetic or thermodynamic stabilizations. Nonetheless, steric congestion or excessive coordination of donor atoms to the cationic center concurrently disfavors its prompt reactivity. Our research in this field revolves around the utilization of structurally non-rigid bis(imine) based tetradentate supporting ligands for the stabilization of Ge(II) and Sn(II) cationic species.

Testing alone is insufficient.

The fear of contracting a serious illness caused by a contagious disease limits economic activity even after reopening. Widespread testing alone will not alleviate this problem. We argue that targeted testing in concert with targeted transfers is essential.

Recent Developments in the Chemistry of Pn(I) (Pn=N, P, As, Sb, Bi) Cations.

The Group 15 Pn(I) cations (Pn=N, P, As, Sb and Bi), which are isoelectronic with the donor-stabilized carbones, have emerged recently. Despite the presence of two lone pair of electrons, the Pn(I) cations are weakly nucleophilic due to their inherent positive charge. Strongly electron-donating supporting ligands including zwitterionic forms have been used to enhance their Lewis basicity.

Impact of COVID-19 on the practice of breast pathologists: a survey of breast pathologists in the UK and Ireland.

Aims: There is little information on the impact of COVID-19 on breast pathologists. This survey assessed the effect of the COVID-19 pandemic on UK and Ireland-based breast pathologists to optimise working environments and ensure preparedness for potential future pandemics.

Methods: A 35-question survey during the first wave of COVID-19 infections in the UK including questions on workload, working practices, professional development, training, health and safety and well-being was distributed to consultant breast pathologists and responses collected anonymously.

Intramolecularly Double-Donor-Stabilized Stannylene and Its Coordination towards Ag(I) and Au(I) Centers.

The intramolecularly double-donor-stabilized stannylene 1 has been synthesized from the salt-metathesis reaction between two equivalents of lithium pyridine ene-amide L1 and SnCl . Compound 1 exhibits dipolar behavior when reacted with B(C F ) leading to the zwitterionic compound 2. The reaction of 1 with one equivalent and 0.

Multidisciplinary team approach in breast cancer care: Benefits and challenges.

The multidisciplinary team approach has been employed internationally for decades, as an attempt to bring collaborative decision-making and concentrate clinical experience from multiple specialties on single patient cases in a systematic fashion. Adoption is not yet worldwide, but is increasing. The role of the histopathologist is central, providing vital information and context to clinical diagnosis and management.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): an overview of presentation and pathogenesis and guidelines for pathological diagnosis and management.

Aims: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon complication associated largely with textured implants. It is important that the symptoms associated with BIA-ALCL are recognised and that robust pathways are in place to establish the diagnosis. The aim of this paper is to review what is known of the incidence of the disease, current thoughts on pathogenesis, patterns of presentation and pathological features to provide standard guidelines for its diagnosis.

Accuracy of classification of invasive lobular carcinoma on needle core biopsy of the breast.

Although the UK National Institute for Health and Care Excellence guidelines recommend that in patients with biopsy-proven invasive lobular carcinoma (ILC), preoperative MRI scan is considered, the accuracy of diagnosis of ILC in core biopsy of the breast has not been previously investigated. Eleven pathology laboratories from the UK and Ireland submitted data on 1112 cases interpreted as showing features of ILC, or mixed ILC and IDC/no special type (NST)/other tumour type, on needle core biopsy through retrieval of histology reports. Of the total 1112 cases, 844 were shown to be pure ILC on surgical excision, 154 were mixed ILC plus another type (invariably ductal/NST) and 113 were shown to be ductal/NST.

National survey of B1 and B2 reporting of breast needle core biopsies.

Aim: This survey investigated the variation in the use of the breast core biopsy categories B1 normal and B2 benign.

Method: A survey with case scenarios was circulated to 701 breast pathologists in the UK.

Results: The response rate was 40%.

Evaluating the predictive value of biomarkers for efficacy outcomes in response to pertuzumab- and trastuzumab-based therapy: an exploratory analysis of the TRYPHAENA study.

Introduction: Molecular markers that predict responses to particular therapies are invaluable for optimization of patient treatment. The TRYPHAENA study showed that pertuzumab and trastuzumab with chemotherapy was an efficacious and tolerable combination for patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer in the neoadjuvant setting. We analyzed whether particular biomarkers correlated with the responses observed and therefore may predict outcomes in patients given pertuzumab plus trastuzumab.

Invasive lobular carcinoma arising in accessory breast tissue.

Background: Lobular carcinoma in accessory breast tissue is a rare occurrence. We present such a case in a 61-year-old woman.

Case Presentation: A skin nodule in the axillary skin on excision biopsy revealed invasive lobular carcinoma.