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Grading of breast cancer on needle core biopsy: does a reduction in mitotic count threshold improve agreement with grade on excised specimens?
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  • Published on:
    Authors Response: Histological grade in needle core biopsies of invasive carcinoma of the breast: the potential role of reduction of mitotic count threshold in improving agreement with grade in the surgical specimen
    • Joseph F Loane, Consultant Pathologist
    • Other Contributors:
      • Catharine A Dhaliwal and Catriona Graham

    Dear Sir / Madam,

    We are happy to address the points raised by Lee et al in their commentary on our paper [1] and thank them for their interest in it.

    Lee et al correctly note that our re-assessment was of the mitotic count in these specimens. To clarify, these were carried out by either of two observers (CAD, JL) blinded to the original core and excision grading. The other elements of the tumour grade...

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    Conflict of Interest:
    None declared.
  • Published on:
    Histological grade in needle core biopsies of invasive carcinoma of the breast: the potential role of reduction of mitotic count threshold in improving agreement with grade in the surgical specimen.
    • Andrew HS Lee, Consultant Histopathologist
    • Other Contributors:
      • Emad A Rakha, Zsolt Hodi, Ian O Ellis

    Accurate histological grading of invasive carcinoma of the breast in needle core biopsies is important for patient management, for example for selecting patients for neoadjuvant chemotherapy. The grade in the core biopsy tends to underestimate the grade in the excision specimen, particularly due to underestimation of the mitotic count. We recently proposed a reduction in the threshold for the mitotic count which we found...

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    Conflict of Interest:
    None declared.