The subgross morphology of breast carcinomas: a single-institution series of 2033 consecutive cases documented in large-format histology slides

  • Tibor TotEmail author
  • Maria Gere
  • Syster Hofmeyer
  • Annette Bauer
  • Ulrika Pellas
Original Article


A large-format histology technique represents the most convenient method for documenting and assessing the subgross morphological prognostic parameters of breast cancer (i.e., the distribution of the tumor’s invasive and in situ components, disease extent, and tumor size), especially when used in conjunction with systematic radiological–pathological correlation. Here we report a consecutive series of 2033 breast carcinomas operated on in Dalarna, Sweden, with a particular focus on these subgross parameters. We separately analyzed the distributions of the in situ and invasive components of the tumors and then combined these into an aggregate pattern when both components were present. We found that 40% of breast carcinomas had a simple (unifocal) subgross morphology, while 60% had a complex morphology presenting with multifocal or diffuse components. Extensive tumors (occupying a total volume of breast tissue with the greatest dimension being ≥ 40 mm) were more common in complex cases, occurring in 66% of multifocal cases and 88% of diffuse cases, compared with only 5% of unifocal cases. Compared with luminal A–like tumors, HER2-expressing tumors exhibited a significantly larger extent. Triple-negative and basal-like carcinomas tended to have a larger tumor size (based on the largest dimension of the largest invasive focus). In this report, we discuss the prognostic impact of these parameters and the necessity of their correct assessment in the diagnostic routine.


Large-format histopathology Multifocality Diffuse breast cancer Disease extent 



Design of the work: Tibor Tot; data acquisition, analysis, and interpretation: all authors; drafting the manuscript: Tibor Tot and Ulrika Pellas; revising the manuscript: all authors; final approval of the version to be published: all authors; and agreement to be accountable for all aspects of the work: all authors.


Funding was received for this study from the Center for Clinical Research Dalarna, Falun, Sweden (Drn. CKFUU-900271).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pathology & Cytology DalarnaCounty Hospital FalunFalunSweden
  2. 2.Center for Clinical Research DalarnaFalunSweden

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