Breast - Pathology

This is the site specific section for additional breast cancer specific data items to be recorded. These will be aligned within the schema to form a single report. 

Most data items are required but must be reported if applicable to the specimen and/or tumour. Although there are some that are set to optional, these are still important data items and would be useful to receive within the data export.

May be up to one occurrence per pathology report (0..1)

Disease Extent

Disease extent, is the tumour localised or are there multiple invasive foci in the same breast?

Notes:

• the data item has a new name, previously ‘Multifocal Tumour Indicator (Breast)’
• all the national codes and definitions have been updated to meet the ‘RCPath Core’ data set

DCIS grade

If ductal carcinoma in situ is present, record the DCIS grade. This is the cytonuclear grade.

DCIS/pleomorphic or DCIS like LCIS Size

Record the size of the non-invasive tumour in mm. This is only required if there is no invasive component.

Notes:

• for COSD reporting purposes, this data item can be submitted to 2 decimal places

• as the new RCPath Breast data set (Nov2024) and proforma definitions do not match those in the current COSD data set, the following advice is given when recording this data item

  • if one or other field (of DCIS size or LCIS size) is completed then send that, but if both are completed, I don’t think we can instruct what to do – so probably send neither?

  • this will be corrected in the next version of COSD Pathology

Whole Tumour (Invasive + DCIS) Size

Record the whole size of the tumour (invasive + surrounding DCIS, if DCIS extends >1mm beyond invasive) (mm) (For tumours without a DCIS component this will be the same as invasive lesion size).

Note:

• for COSD reporting purposes, this data item can be submitted to 2 decimal places

Metastasis Extent Code

For single node positivity, specify micrometastatic status as follows: Greater than 2mm = Metastases, 2mm to greater than 0.2mm = Micrometastasis, less than or equal to 0.2mm = Isolated tumour cells.

Distance to Margin

Distance to closest relevant margin (mm). Record the smallest value from the superior, inferior, medial, lateral and nipple margins whether invasive or non-invasive. (For COSD measurement to the nearest mm is sufficient but may be recorded to nearest tenth of mm).

ER Allred Score

ER Allred score (range 0, 2 -8). This is an optional data item as it is not in the ‘RC Path Core’ data set.

ER Status

Oestrogen Receptor (ER) status. (A positive score means that oestrogen is causing the tumour to grow, and a negative score means that the tumour is not driven by oestrogen).

PR Allred Score

Record the 'PR Allred score' if known. (Range 0, 2-8). This is an optional data item as it is not in the ‘RC Path Core’ data set.

PR Status

Progesterone Receptor Status. Record the PR status if known. This is an optional data item as it is not in the ‘RC Path Core’ data set.

HER2 IHC Score

HER2 Immunohistochemical status (Human Epidermal Growth Factor Receptor 2). Where the initial result of this test is ‘Borderline’, a further report will follow with result of the ISH test.

Note:

• the data item has a new name, previously ‘HER2 Status’

HER2 ISH Status

Record the result of the ISH (in situ hybridization) test. This is only required if the initial HER2 status is ‘Borderline’.

Note:

• ‘P’ and ‘N’ national code definitions have been updated to meet the ‘RCPath Core’ data set

Cytology (Breast)

Cytology opinion (Breast).

Cytology (Node)

Cytology opinion on axillary lymph node.

Note:

• all national codes have been updated to meet the ‘RCPath Core’ data set

Core Biopsy (Breast)

Needle core biopsy opinion.

Core Biopsy (Node)

Needle biopsy opinion on axillary lymph node.