[HER2 epidermal growth factor receptor, tests used to look for its amplification in breast cancer: Principles and limitations]. / Récepteur du facteur de croissance épidermique HER2, tests utilisés pour rechercher son amplification dans le cancer du sein : principes et limites.

HER2-positive breast cancer accounts for 20 % of all invasive breast cancers. It is associated with increased recurrence, a higher risk of brain metastases and a shorter overall survival than luminal A and B cancers. The presence of ERBB2 gene amplification is predictive of a good response to anti-HER2 therapies. Determining HER2 status is a hot topic, given recent studies on HER2-low subtypes. Although several techniques are available, the latest 2018 update from the American Society of Clinical Oncology and College of American Pathologists (ASCO/CAP) recommends a first immunohistochemical study followed by a fluorescence in situ hybridisation study indicated only for equivocal cases. This article summarises the different techniques used to determine HER2 status and provides a detailed review of the literature on pre-analytical factors and intrinsic tumour-specific factors that can distort or complicate the interpretation of results.

Exploring real-world practices and challenges of sarcoma diagnosis in Morocco: A survey-based study among 144 pathologists.

BACKGROUND AND AIM: Sarcoma diagnosis is a challenge for laboratories of cytopathology and anatomic pathology. We conducted this survey-based study to better elucidate real-world practices and challenges of sarcoma diagnosis.  Methods: This was a cross-sectional study using an anonymous questionnaire. The survey was distributed among pathologists using snowball sampling. Descriptive statistics were used to report the finding of this survey. RESULTS: A total of 144 Moroccan pathologists were surveyed. Most respondents were from academic institutions (41.7%) and those with a specialization in sarcoma diagnosis represented 57%, through training using post-graduate fellowships followed by internships abroad and inter-university diplomas. Remarkably, 36.8% of participants reported no training on sarcoma pathology during their career. Regarding frequency of sarcoma diagnosis, 64.6% of pathologists reported having received less than one case of sarcoma per week and more than 70% did not receive sufficient information from referring clinicians. The majority of pathologists reported their nonattendance in multidisciplinary meetings. Morphology and immunohistochemistry were the most frequently used diagnostic tools, while fluorescence in situ hybridization and other molecular biology techniques were accessible for only 27% and 20.1% of pathologists, respectively. Response time during pathological diagnosis of sarcoma was 14 days according to 52.8% of surveyed participants. In addition, a second opinion was needed for 66% of pathologists. CONCLUSIONS: Specialized training on sarcoma pathology in Morocco is lacking. A national working group on sarcoma pathology is needed to provide second opinions, and therefore, improve the management of this malignancy of poor prognosis. (www.actabiomedica.it).

Trial of a Rare Diagnosis in a Core Needle Biopsy of Breast.

OBJECTIVE: Mucinous carcinoma is a rare, special subtype of breast carcinoma associated with a good prognosis. It often presents a confusing appearance with a benign process. For all these reasons, differential diagnosis could be challenging. CASE REPORT: Eighty years-old woman with a soft, lobulated, and well circumscribed mass at the left breast mimicking a benign process. Pathological examination of a core needle biopsy showed pure mucinous carcinoma. DISCUSSION: It is a disease of elderly patient, over 60 years, and usually occurs in postmenopausal women. It accounts for only 2% of total breast carcinomas. On pathologic analysis, to be defined as pure mucinous carcinoma, a carcinoma must be made up of at least 90% intracellular or extracellular mucin. CONCLUSION: Examination of core biopsy material should be done carefully respecting this criteria to confirm the diagnosis of this rare entity and eliminate differential diagnosis.