scholarly journals Breast cancer prognostic factors in the digital era: Comparison of Nottingham grade using whole slide images and glass slides

2019 ◽  
Vol 10 (1) ◽  
pp. 11 ◽  
Author(s):  
JoannG Elmore ◽  
TaraM Davidson ◽  
MaraH Rendi ◽  
PaulD Frederick ◽  
Tracy Onega ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Digital Era ◽  
Glass Slides ◽  
Nottingham Grade ◽  
Whole Slide Images

scholarly journals Pathologists' Computer-Assisted Diagnosis: A Mock-up of a Prototype Information System to Facilitate Automation of Pathology Sign-out

2017 ◽  
Vol 141 (10) ◽  
pp. 1413-1420 ◽  
Author(s):  
Navid Farahani ◽  
Zheng Liu ◽  
Dylan Jutt ◽  
Jeffrey L. Fine
Keyword(s):  
Breast Cancer ◽  
Computer Assisted ◽  
Pathology Report ◽  
Heterogeneous Information ◽  
Computer Assisted Diagnosis ◽  
Glass Slides ◽  
Cancer Specimen ◽  
Assisted Diagnosis ◽  
Deep Integration ◽  
Whole Slide Images

Context.— Pathologists' computer-assisted diagnosis (pCAD) is a proposed framework for alleviating challenges through the automation of their routine sign-out work. Currently, hypothetical pCAD is based on a triad of advanced image analysis, deep integration with heterogeneous information systems, and a concrete understanding of traditional pathology workflow. Prototyping is an established method for designing complex new computer systems such as pCAD. Objective.— To describe, in detail, a prototype of pCAD for the sign-out of a breast cancer specimen. Design.— Deidentified glass slides and data from breast cancer specimens were used. Slides were digitized into whole-slide images with an Aperio ScanScope XT, and screen captures were created by using vendor-provided software. The advanced workflow prototype was constructed by using PowerPoint software. Results.— We modeled an interactive, computer-assisted workflow: pCAD previews whole-slide images in the context of integrated, disparate data and predefined diagnostic tasks and subtasks. Relevant regions of interest (ROIs) would be automatically identified and triaged by the computer. A pathologist's sign-out work would consist of an interactive review of important ROIs, driven by required diagnostic tasks. The interactive session would generate a pathology report automatically. Conclusions.— Using animations and real ROIs, the pCAD prototype demonstrates the hypothetical sign-out in a stepwise fashion, illustrating various interactions and explaining how steps can be automated. The file is publicly available and should be widely compatible. This mock-up is intended to spur discussion and to help usher in the next era of digitization for pathologists by providing desperately needed and long-awaited automation.

scholarly journals Understanding risk factors in grade 3 breast cancer in NZ

2020 ◽  
Author(s):  
Sharita Meharry ◽  
Reena Ramsaroop ◽  
Robert Borotkanics ◽  
Fabrice Merien
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
New Zealand ◽  
Survival Rates ◽  
Elevated Risk ◽  
Pacific Islanders ◽  
High Grade ◽  
Grade 3 ◽  
Nottingham Grade ◽  
Survival Differences

Abstract Background Breast cancer is the most common cancer in New Zealand women, accounting for approximately 3000 new registrations per year, affecting one in nine women and resulting in more than 600 deaths annually. This study analysed data of patients selected with prognostic factor of Nottingham grade 3 tumours over a specified five- year period. These represent a heterogeneous group of cancers with variable survival rates. Method All women diagnosed with Nottingham grade 3 invasive breast cancer between 1 st January 2011 to 31 st December 2015, from four Breast Cancer Registries in New Zealand (Auckland, Waikato, Christchurch, and Wellington) were studied. Results Applying Fine-Gray analyses, the study of 2,493 women found that subjects in the older age group (>70 years) had a higher five-year mortality risk (SHR: 1.74 to 2.25, p: 0.053 to <0.001). Analysis of hormonal receptors showed that tumours with hormonal profile ER-positive, PR negative and ER-negative, PR negative subjects were at increased mortality risk (SHR: 3.56, p: <0.001) and (SHR: 2.67, p: <0.001) respectively. Molecular subtypes TNBC and Luminal B subjects were at increased risk of five-year mortality (SHR: 3.01 and 3.35 respectively, both p: <0.001). HER2 enriched subjects, were at elevated risk (SHR: 1.66, p: 0.11). Women identifying as NZ European ethnicity were at elevated risk of mortality overall (SHR: 1.70, p: 0.11), and they presented with the highest CIF across ethnicities. The NZ Europeans represented the largest proportion of HER2 enriched and TNBC subjects; however, Pacific Islanders experienced the highest HER2 CIF. Conclusion The survival rates for grade 3 breast cancer vary across the selected prognostic factors and ethnicity. Although grade 3 breast cancer is considered as high grade heterogeneous cancer, this study showed that not every patient has a poor outcome. NZ Europeans are worst affected followed by Pacific Islanders. Biology of the cancer and ethnicity needs to be looked at as a possible factor associated with this disease for survival differences. The results of this study make an initial contribution to the understanding of high-grade malignancy and other prognostic factors must be included in order to get a better understanding of survival differences.

Prognostic Factors in Breast Cancer

1989 ◽  
Vol 3 (4) ◽  
pp. 641-652 ◽  
Author(s):  
Douglas E. Merkel ◽  
C. Kent Osborne
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors

Prognostic Factors in Breast Cancer

1997 ◽  
Author(s):  
Timothy J. O'Leary ◽  
Jeffrey D. Seidman
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors

scholarly journals A Digital Pathology Solution to Resolve the Tissue Floater Conundrum

2020 ◽  
Author(s):  
Liron Pantanowitz ◽  
Pamela Michelow ◽  
Scott Hazelhurst ◽  
Shivam Kalra ◽  
Charles Choi ◽  
...  
Keyword(s):  
Digital Pathology ◽  
Primary Diagnosis ◽  
Image Search ◽  
Molecular Tests ◽  
Tissue Identification ◽  
Digital Database ◽  
Glass Slides ◽  
Search Tool ◽  
Hematoxylin And Eosin ◽  
Whole Slide Images

Context.— Pathologists may encounter extraneous pieces of tissue (tissue floaters) on glass slides because of specimen cross-contamination. Troubleshooting this problem, including performing molecular tests for tissue identification if available, is time consuming and often does not satisfactorily resolve the problem. Objective.— To demonstrate the feasibility of using an image search tool to resolve the tissue floater conundrum. Design.— A glass slide was produced containing 2 separate hematoxylin and eosin (H&E)-stained tissue floaters. This fabricated slide was digitized along with the 2 slides containing the original tumors used to create these floaters. These slides were then embedded into a dataset of 2325 whole slide images comprising a wide variety of H&E stained diagnostic entities. Digital slides were broken up into patches and the patch features converted into barcodes for indexing and easy retrieval. A deep learning-based image search tool was employed to extract features from patches via barcodes, hence enabling image matching to each tissue floater. Results.— There was a very high likelihood of finding a correct tumor match for the queried tissue floater when searching the digital database. Search results repeatedly yielded a correct match within the top 3 retrieved images. The retrieval accuracy improved when greater proportions of the floater were selected. The time to run a search was completed within several milliseconds. Conclusions.— Using an image search tool offers pathologists an additional method to rapidly resolve the tissue floater conundrum, especially for those laboratories that have transitioned to going fully digital for primary diagnosis.

Proof of Concept: The Use of Whole-Slide Images (WSI) for Peer Review of Tissues on Routine Regulatory Toxicology Studies

2021 ◽  
pp. 019262332098325
Author(s):  
Alys E. Bradley ◽  
Maurice G. Cary ◽  
Kaori Isobe ◽  
Stuart Naylor ◽  
Stephen Drew
Keyword(s):  
Peer Review ◽  
Proof Of Concept ◽  
Regulatory Toxicology ◽  
Glass Slides ◽  
Microscopic Findings ◽  
Slight Discrepancy ◽  
Whole Slide Images ◽  
Diagnostic Discrepancies

This Proof of Concept (POC) study was to assess whether assessment of whole slide images (WSI) of the 2 target tissues for a contemporaneous peer review can elicit concordant results to the findings generated by the Study Pathologist from the glass slides. Well-focused WSI of liver and spleen from 4 groups of mice, that had previously been diagnosed to be the target tissues by an experienced veterinary toxicologic pathologist examining glass slides, were independently reviewed by 3 veterinary pathologists with varying experience in assessment of WSIs. Diagnostic discrepancies were then reviewed by an experienced adjudicating pathologist. Assessment of microscopic findings using WSI showed concordance with the glass slides, with only slight discrepancy in severity grades noted. None of the lesions recorded by the Study pathologist were “missed” and no lesions were added by the pathologists evaluating WSIs, thus demonstrating equivalence of the WSI to glass slides for this study.

scholarly journals Surgery for primary tumor benefits survival for breast cancer patients with bone metastases: a large cohort retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhangheng Huang ◽  
Xin Zhou ◽  
Yuexin Tong ◽  
Lujian Zhu ◽  
Ruhan Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Predictive Accuracy ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
The Impact

Abstract Background The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM. Methods A total of 3956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms. Result The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis. Conclusion The surgery of the primary tumor may provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed may be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

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