Breast Pathology and Cancer Diagnosis

Biography

Biography: Hallgeir Rui

Abstract

Breast cancer is a heterogeneous disease and there is a great need for individualized treatment. Immunohistochemistry provides valuable spatially resolved marker analysis at the tissue level, which is valuable due to extensive inter tumor and intratumor heterogeneity. Pathologists typically evaluate protein marker expression visually in formalin-fixed paraffin-embedded tumor sections by chromogenic immunohistochemistry. However, pathologist scoring of chromogen staining intensity is subjective, and provide only reduced data that is discrete, either ordinal or nominal (negative/positive). In contrast, digital pathology platforms allow quantification of chromogen or fluorescence signals by computer-assisted image analysis, providing continuous signal intensity values. Fluorescence-based immunohistochemistry (IF-IHC) provides greater dynamic signal range than chromogen-immunohistochemistry. Combined with image analysis software, fluorescence-based immunohistochemistry holds potential for enhanced sensitivity and greater analytic resolution, resulting in more robust quantification. We will show novel and unpublished progress with breast cancer markers related to immune checkpoints, proliferation, and metabolism, incorporating signal intensities at the cell-by-cell level and employing new spatial statistics to extract additional layers of therapy-relevant information. The path toward implementation of objective tumor marker quantification in pathology laboratories will be discussed.