Frontiers In Pathology Research Articles

Whole slide image features predict pathologic complete response and poor clinical outcomes in triple-negative breast cancer.

Breast cancers are complex ecosystem like networks of malignant cells and their associated microenvironment. Applications for machine intelligence and the tumoral microenvironment are expanding frontiers in pathology. Previously, computational approaches have been developed to quantify and spatially analyze immune cells, proportionate stroma, and detect tumor budding. Little work has been done to analyze different types of tumor-associated stromata both quantitatively and computationally in relation to clinical endpoints. We aimed to quantify stromal features from whole slide images (WSI) including stromata (myxoid, collagenous, immune) and tumoral components and combined them with traditional clinical and pathologic parameters in 120 triple-negative breast cancer (TNBC) patients treated with neoadjuvant chemotherapy (NAC) to predict pathologic complete response (pCR) and poor clinical outcomes. High collagenous stroma on WSI was best associated with lower rates of pCR, while combined high proportionated stroma (myxoid, collagenous, and immune) most optimally predicted worse clinical survival outcomes. When combining clinical, pathologic, and WSI features, Receiver Operator Characteristics (ROC) curves for LASSO features was up to 0.67 for pCR and 0.77 for poor outcomes. The techniques demonstrated in the present study can be performed with appropriate quality assurance. Future trials are needed to demonstrate whether coupling applications for machine intelligence, inclusive of the tumor mesenchyme, can improve outcomes prediction for patients with breast cancer.

Contributions From the University of Michigan New Frontiers in Pathology 2015 Conference.

Contributions From the University of Michigan New Frontiers in Pathology 2015 Conference.

Keeping pace with New Frontiers in Pathology.

Keeping pace with New Frontiers in Pathology.

Life-Long Learning and Self-Assessment

New Frontiers in Pathology is a unique educational event intended to meet the ongoing educational needs of practicing pathologists. Continuous medical education (CME) is required for maintenance of licensure by virtually all state licensing bodies. Satisfying CME requirements hinges on earning a minimum number of American Medical Association Physician Recognition Award category 1 credits through various activities, including courses like New Frontiers in Pathology that are accredited by the Accreditation Council for Continuing Medical Education. Self-assessment modules (SAMs) are a key component of the American Board of Pathology expectations for maintenance of board certification. Beginning in 2006, the American Board of Pathology granted only time-limited certificates as part of an American Board of Medical Specialties-wide process for maintenance of board certification. Maintenance of board certification has requirements in 4 categories: professional standing, life-long learning and self-assessment, cognitive expertise, and evaluation of performance in practice. Life-long learning and self-assessment includes not only the traditional elements of CME but also the SAMs that are defined as educational products comprising self-administered examinations with a predetermined minimum performance level and a mechanism for receiving feedback. New Frontiers in Pathology will offer SAMs, in addition to the American Medical Association Physician Recognition Award category 1 credits, which it has been accredited to do since its inception, at its 2012 conference scheduled for August 3 through August 5 at The Homestead Resort, Michigan's largest waterfront resort on beautiful Lake Michigan.