Masters Degrees (Anatomical Pathology)

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Browsing Masters Degrees (Anatomical Pathology) by Subject "Breast -- Cancer -- Chemotherapy"

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    Chemotherapy naive breast cancer: a correlation study between BD Cytorich™ Red cell blocks and formalin- fixed paraffinembedded tissue blocks
    (Stellenbosch : Stellenbosch University, 2019-04) Van Rooyen, Evelyn; Schubert, Pawel T.; Schneider, Johann; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology. Anatomical Pathology.
    Background: The ever increasing burden of breast cancer, the most common cancer among women, demands a diagnostic test that is rapid, reliable, informative and cost-effective; particularly in countries with limited financial and medical resources. FNAB cytology and cell block combination has gained worldwide utility and has been described to be accurate and reliable. Aim: Henceforth the aim of this study was to retrospectively correlate the expression of prognostication markers, namely, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) performed on cell blocks (using the BD CytorichTM Red method) and formalin-fixed, paraffin-embedded cell blocks (FFPET) in chemotherapy naive breast carcinomas, by immunochemistry (immunocytochemistry and immunohistochemistry respectively) and to perform fluorescence in-situ hybridization (FISH) testing for over- expression of the HER2 gene. Methods: Between 2013 and 2016, 132 cases of primary breast carcinoma were identified that had both cytology (including Cytorich™ Red cell blocks) and histology specimens that were both chemotherapy naive. Immunostaining for ER, PR and HER2 was performed. The staining was scored according to the Allred scoring system for histology specimen and this system was slightly adapted for cytology specimens, which also took the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines into account. FISH for HER2 over-expression was performed. The grade of the carcinoma was also analysed on both the cytology specimens (using the Robertson’s grading system) and the histology specimens (using the Modified Elston & Ellis system). Results: ER and PR performed on cell blocks had good correlation with FFPET with 91% and 85% sensitivity, respectively. HER2 on cell blocks had an agreement of 88% with FFPET. 87.88% of cell blocks had more than a 100 tumour cells present on H&E sections and cytological grading had an agreement of 41.41% with histological grading. Conclusion: The cell block technique continues to play a vital role in the diagnosis of primary, recurrent and metastatic breast carcinoma, allowing assessment of prognosis and prediction of response to therapy.