PracticeUpdate: Haematology & Oncology

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7. Role of mathematical modelling
A novel subject that reflects the benefit of integration of pathology,
molecular biology and mathematics is in Simmons et al7, which reviews
the role of mathematical modelling and simulation in deciphering
breast cancer heterogeneity and underlying biophysical processes.
Different models are elucidated including equation-based models,
agent-based modelling, multi-scale modelling, lattice-based models and
image-driven modelling. Novel aspects of breast cancer dynamics and
perspectives on the role of mathematical modelling in understanding
breast cancer development, invasion and treatment therapies are
presented.
8. Diagnosing salivary gland-like tumours
Salivary gland-like tumours are rare breast lesions characterised by epi-
thelial and myoepithelial differentiation and they mimic salivary gland
tumours. The morphology and immunoprofile of these lesions are widely
variable and overlapping and these, in addition to their rarity, make their
diagnosis in routine practice a challenging task. Prior knowledge of their
classification, morphologic and immunophenotypic features is essential for
the correct diagnosis, and knowledge of their clinical behaviour is essential
in guidingmanagement decisions. Foschini and colleagues8 in their article
have provided a comprehensive overview of salivary gland-like tumours.
9. Diagnosing vascular proliferations
Vascular lesions are another area of diagnostic challenge. Although
rare, different types of vascular lesions develop in the breast and it is
not uncommon to find difficulty in distinguishing benign/atypical from
malignant vascular entities despite the fundamental difference in the
clinical behaviour andmanagement of the two. The commonplace use of
local radiotherapy is associated with an increased risk of atypical/malig-
nant vascular lesions, and specialist breast pathologists often face the
dilemma of over- or underdiagnosis of low grade angiosarcoma on a core
biopsy in addition to dealing with angiosarcoma in excision specimens.
Ginter and colleagues9 discuss the clinicopathological features of the
most commonly encountered mammary vascular proliferations with
some insight into differential diagnoses and ancillary studies that can
be used to provide the most accurate diagnosis. Knowledge of diagnos-
tic pitfalls in breast pathology can improve the accuracy of reporting
and avoid unnecessary consequences.
10. Mimics of malignancy
Torous and colleagues10 in their review address some benign
entities that may be misinterpreted as malignant lesions (mimics
of malignancy) and describe the salient features of these entities in
an attempt to improve the awareness of such challenging lesions.
Mucocele-like lesions, collagenous spherulosis,tubular adenosis,
granular cell tumour, myofibroblastoma, Toker cells, lymph node
epithelial inclusion and breast epithelial displacement following
biopsy procedures are discussed in details with differential diagnosis,
immunoprofile and management.
These Top 10 topics on breast cancer pathology are available
collectively in a special issue of Pathology ( Pathology 2017; 49). Also
available at
References
1. Rakha EA, Green AR. Pathology 2017;49:111–9.
2. Ross JS, Gay LM. Pathology 2017;49:120–32.
3. McCuaig R, Wu F, Dunn J, et al. Pathology 2017;49:133–40.
4. Ali R, Rakha EA, Madhusudan S, et al. Pathology 2017;49:156–65.
5. Penault-Llorca F, Radosevic-Robin N. Pathology 2017;49:166–71.
6. Luen SJ, Savas P, Fox SB, et al. Pathology 2017;49:141–55.
7. Simmons A, Burrage PM, Nicolau Jr DV, et al. Pathology 2017;49:172–80.
8. Foschini MP, Morandi L, Asioli S, et al. Pathology 2017;49:215–27.
9. Ginter PS, McIntire PJ, Shin SJ. Pathology 2017;49:197–214.
10. Torous VF, Schnitt SJ, Collins LC. Pathology 2017;49:181–96.
New drug listings
PHARMACEUTICAL BENEFITS SCHEME
Ceritinib (Zykadia), Novartis – non-small cell lung cancer
Olaparib (Lynparza) , AstraZeneca – ovarian cancer
Ixekizumab (Taltz), Eli Lilly – plaque psoriasis
Peginterferon alfa-2a (Pegasys), Roche – hepatitis B, C
Tiotropium (Spiriva Respimat), Boehringer Ingelheim – asthma, chronic
obstructive pulmonary disease
Please consult the full Product Information before prescribing.
The Rare Haematology Resource Centre is funded by Sanofi Genzyme and developed by Elsevier. Sanofi Genzyme has no editorial control over the content of the Resource Centre. All content
therein has been subject to an independent editorial review.
Sanofi Genzyme is the specialty care global business unit of Sanofi, focused on rare diseases, multiple
sclerosis, oncology and immunology. 12–24 Talavera Road, Macquarie Park NSW 2113 Australia.
Date of preparation: January 2017. GZANZ.CERZ.17.01.0006
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