Nottingham & Singapore Breast Pathology Online Masterclass
Advances in Breast Pathology Diagnosis and Classification – Part 2Slide Cases
The Online Masterclass includes a slide seminar session.
Each of the seven cases below will be examined and discussed in detail. We invite you to review each case and submit your own diagnosis from the choice provided before the masterclass.
For each case, we have provided the relevant images, clinical data and a number of options for the diagnosis for you to choose from. Please complete the slide survey – use the Mentimeter form to enter your diagnosis, linked HERE and at foot of this page.
Please review the cases and submit your opinion by 5pm (UK time), 25 May.
Submitted responses will be used to guide the discussions in the case presentations. Respondent details will not be used or referred to.
Please keep a note of your choices as you choose them if you wish to refer to these during the slide seminars. Unfortunately we cannot provide a summary report of your submission.
To view the slide images
To open the image(s) for each case you will firstly need to log into the PathXL slide viewer where the images are hosted:
1. Enter the url in your internet browser: https://pathxl.co.uk
2. Against Account Name, enter: nottinghamuninhs
3. Against Username, enter: Masterclass2025
4. Against Password, enter: ERPhT2025
5. Keep the homepage open on your browser and return to the slide survey.
Now you can complete the slide survey in the Mentimeter form
If you have any issues viewing the cases, please firstly try changing your browser. For any other queries, please contact Jenny Baldwin at jennifer.baldwin@nottingham.ac.uk
Slide Seminar
Dr Elena Provenzano
Dr Elena Provenzano is Lead Breast Histopathologist for the Cambridge Breast Unit at Addenbrooke’s Hospital. Her role combines clinical work and research, with key interests in the molecular taxonomy of breast cancer and assessment of tumour response to neoadjuvant therapy.
CAMBRIDGE
Case 1
Clinical Data:
25 year old man. Bilateral excision for gynaecomastia.
Diagnosis Options:
- Gynaecomastia with hyperplasia
- Gynaecomastia with atypical ductal hyperplasia
- Gynaecomastia with low grade DCIS
Dr Elena Provenzano
Dr Elena Provenzano is Lead Breast Histopathologist for the Cambridge Breast Unit at Addenbrooke’s Hospital. Her role combines clinical work and research, with key interests in the molecular taxonomy of breast cancer and assessment of tumour response to neoadjuvant therapy.
CAMBRIDGE
Case 2
Clinical Data:
40 year old female. Right breast lump.
Diagnosis Options:
- Complex fibroadenoma with squamous metaplasia
- Complex fibroadenoma with low grade adenosquamous proliferation
- Complex fibroadenoma with low grade adenosquamous carcinoma
Professor Abeer Shaaban
Dr Shaaban is a specialist breast pathologist at Queen Elizabeth Hospital Birmingham and Honorary Senior Lecturer at the University of Birmingham. She trained in anatomic pathology in Liverpool, Birmingham and Leeds. She completed her PhD in molecular pathology at the University of Liverpool with the late Prof John Sloane.
BIRMINGHAM
Case 3
Clinical Data:
Known right breast cancer with diffuse calcification, this is repeat biopsy from right peri areolar area, previously B1.
Diagnosis Options:
- Simple cyst/duct
- Simple cyst/duct with mild atypia
- AIDEP suspicious of DCIS
- Fibroadenoma with epithelial hyperplasia
Professor Abeer Shaaban
Dr Shaaban is a specialist breast pathologist at Queen Elizabeth Hospital Birmingham and Honorary Senior Lecturer at the University of Birmingham. She trained in anatomic pathology in Liverpool, Birmingham and Leeds. She completed her PhD in molecular pathology at the University of Liverpool with the late Prof John Sloane.
BIRMINGHAM
Case 4
Clinical Data:
84 years old female, excision of a breast lesion
Diagnosis Options:
- Mixed ductal and mucinous carcinoma
- Invasive mucinous carcinoma
- Metaplastic carcinoma (matrix producing)
- Invasive lobular carcinoma with extracellular mucin
Professor Cecily Quinn
Professor Quinn is a Consultant Histopathologist
St. Vincent’s University Hospital (SVUH),
Dublin, Ireland.
DUBLIN
Case 5
Clinical Data:
Female 25, right sided palpable breast lump. Imaging findings: cystic spaces posterior to nipple ? duct ectasia. Code R3.
Submitted slide = needle core biopsy, ultrasound guided.
Diagnosis Options:
- Benign cysts with apocrine metaplasia
- Atypical apocrine hyperplasia
- Apocrine DCIS
- Apocrine adenosis
Professor Edi Brogi
Professor Edi Brogi, MD PhD practices at Memorial Sloan-Kettering Cancer Center, with a focus on the diagnosis of breast diseases.
MSKCC NEW YORK
Case 6
Clinical Data:
59 year old female with a palpable breast mass. The core biopsy material was negative for high molecular weight cytokeratins, p63 and CD34; beta-catenin staining as provided. (cbx 2 digital slides: 1 HE and 1 beta-catenin stain). The mass was excised (1HE). In the next 4 years the tumor recurred twice, and the patient eventually underwent mastectomy.
Diagnosis Options:
- Fibromatosis
- Low grade fibromyxoid sarcoma
- Phyllodes tumour with nuclear expression of beta-catenin and myxoid stroma
- “Fibromatosis-like” spindle cell carcinoma
- Solitary fibrous tumour
Case 6 – beta-catenin:
https://pathxl.co.uk/iscope/pxlviewer/default.aspx/?resid=256765
Case 6 – first excision:
https://pathxl.co.uk/iscope/pxlviewer/default.aspx/?resid=256766
Professor Edi Brogi
Professor Edi Brogi, MD PhD practices at Memorial Sloan-Kettering Cancer Center, with a focus on the diagnosis of breast diseases.
MSKCC NEW YORK
Case 7
Clinical Data:
36 year old female, 37 weeks pregnant with a new 2.5-3 cm breast mass underwent core needle biopsy.
Diagnosis Options:
- Fibromatosis
- Low grade fibromyxoid sarcoma
- Phyllodes tumour
- Fibromatosis-like spindle cell carcinoma
- Pseudoangiomatous stromal hyperplasia (PASH)
CPD/CME
Each masterclass is approved by the Royal College of Pathologists (8 CPD points). Approval is pending from the Singapore Medical Council (4 CME points).
• ALL registered attendees will receive a Certificate of Participation
• The Certificate enables you to claim CPD/CME points
Send a Message
Course Directors
Prof Emad Rakha and
Prof Puay Hoon Tan
Course Moderators
Dr Areeg Abbas
Course Contact
Geoff Cross