[In the face of climate change, is a relevant and sustainable eco-pathology in France possible?] / Face au changement climatique, un écosoin pertinent et sobre en anatomo-pathologie en France est-il possible ?

INTRODUCTION: The healthcare sector is a major contributor to greenhouse gas emissions, accounting for 8 % of annual French emissions. Eco-design in healthcare, which provides care with equal quality, safety, and relevance but with a lower environmental impact, is therefore a crucial lever for sustainable medical practice. This article explores the application of eco-design in anatomical and cytopathological practices (ACP) in France, in response to the country's decarbonization goals. OBJECTIVES: After demonstrating that decarbonization is possible through the chosen eco-design of care and practices in ACP, we describe the barriers to these changes and the potential real-world solutions. DISCUSSION: We examine the challenges and solutions for integrating eco-design principles into daily ACP practice, highlighting the importance of the relevance of medical procedures to reduce unnecessary practices. We discuss the technical and human barriers in ACP, as well as the solutions: raising awareness among laboratory personnel, industrial stakeholders, research and innovation, the involvement of scientific societies, and initiatives from the collective for Ecological Transformation in ACP (TEAP). Finally, we propose financial incentives to make eco-friendly practices economically viable in ACP. CONCLUSION: Eco-design in ACP practices is essential to address the climate challenge and ensure the sustainability of the healthcare system.

Secretory Breast Carcinoma: A Histopathologic and Genomic Spectrum Characterized by a Joint Specific ETV6-NTRK3 Gene Fusion.

Secretory breast carcinoma (SBC) is a rare breast carcinoma with distinctive morphologic features and a recurrent specific chromosomal translocation t(12;15)(p13;q25), usually of low histologic grade and favorable prognosis. We describe the morphologic and genetic characteristics of 11 cases of SBC from 10 patients. Histologic and immunohistochemical analyses, fluorescence in situ hybridization using break-apart probes specific to ETV6 on 12p13, reverse transcription polymerase chain reaction with in-house probes specific to the ETV6-NTRK3 gene fusion, and DNA copy number variation by array comparative genomic hybridization analyses were performed on all cases. Seven cases were of low histologic grade, 3 were intermediate, and 1 had high-grade nuclear atypia, necrosis, and numerous mitoses. This patient had a fatal outcome. Five cases displayed low hormonal receptor expression, whereas the rest had basal-type immunoprofiles. All interpretable cases harbored an ETV6-NTRK3 gene fusion by reverse transcription polymerase chain reaction and/or an ETV6 rearrangement by fluorescence in situ hybridization, with duplication of the oncogenic derivative in 2 cases. Array comparative genomic hybridization analysis showed simplex genomic profiles. The 2 cases with ETV6-NTRK3 duplication included a gain of 12p starting from the ETV6 locus to the telomere, associated with a gain of the 15q from the centromere to NTRK3 in 1 case, and in the other a normal profile up to NTRK3 on 15q, and then a loss up to the telomere, suggesting loss of corresponding normal chromosome 15. These findings provide a novel insight into the morphologic and genetic spectrum of SBC, ranging from low-grade to high-grade histology, with occasional low hormonal receptor expression, simplex genomic profiles, and possible unfavorable course.