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Breast lesions of uncertain malignant nature and limited metastatic potential: proposals to improve their recognition and clinical management.

Identifieur interne : 002A35 ( Ncbi/Merge ); précédent : 002A34; suivant : 002A36

Breast lesions of uncertain malignant nature and limited metastatic potential: proposals to improve their recognition and clinical management.

Auteurs : Emad A. Rakha [Royaume-Uni] ; Sunil Badve [États-Unis] ; Vincenzo Eusebi [Italie] ; Jorge S. Reis-Filho [États-Unis] ; Stephen B. Fox [Australie] ; David J. Dabbs [États-Unis] ; Thomas Decker [Allemagne] ; Zsolt Hodi [Royaume-Uni] ; Shu Ichihara [Japon] ; Andrew H S. Lee [Royaume-Uni] ; José Palacios [Espagne] ; Andrea L. Richardson [États-Unis] ; Anne Vincent-Salomon [France] ; Fernando C. Schmitt [Luxembourg (pays)] ; Puay-Hoon Tan [Singapour] ; Gary M. Tse [Hong Kong] ; Ian O. Ellis [Royaume-Uni]

Source :

RBID : pubmed:26348644

Descripteurs français

English descriptors

Abstract

Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are classified traditionally into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey zone between benign and malignant, as their behaviour cannot be predicted reliably. Defined pathological categorization of such lesions is challenging, and for some entities is recognized to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over- or undertreatment. The rarity of these lesions makes the acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision-making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification and behaviour, and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential, such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions of uncertain malignant nature remain, such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of (1) breast lesions of uncertain malignant nature and (2) breast lesions of limited metastatic potential are proposed with details of which histological entities could be included in each category, and their management implications are discussed.

DOI: 10.1111/his.12861
PubMed: 26348644

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pubmed:26348644

Le document en format XML

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<name sortKey="Tse, Gary M" sort="Tse, Gary M" uniqKey="Tse G" first="Gary M" last="Tse">Gary M. Tse</name>
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<settlement type="city">Sha Tin</settlement>
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<name sortKey="Ellis, Ian O" sort="Ellis, Ian O" uniqKey="Ellis I" first="Ian O" last="Ellis">Ian O. Ellis</name>
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<nlm:affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</nlm:affiliation>
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<name sortKey="Fox, Stephen B" sort="Fox, Stephen B" uniqKey="Fox S" first="Stephen B" last="Fox">Stephen B. Fox</name>
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<name sortKey="Dabbs, David J" sort="Dabbs, David J" uniqKey="Dabbs D" first="David J" last="Dabbs">David J. Dabbs</name>
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<nlm:affiliation>University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</nlm:affiliation>
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<name sortKey="Decker, Thomas" sort="Decker, Thomas" uniqKey="Decker T" first="Thomas" last="Decker">Thomas Decker</name>
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<name sortKey="Hodi, Zsolt" sort="Hodi, Zsolt" uniqKey="Hodi Z" first="Zsolt" last="Hodi">Zsolt Hodi</name>
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<name sortKey="Ichihara, Shu" sort="Ichihara, Shu" uniqKey="Ichihara S" first="Shu" last="Ichihara">Shu Ichihara</name>
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<nlm:affiliation>Department of Pathology, Nagoya Medical Center, Nagoya, Japan.</nlm:affiliation>
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<name sortKey="Lee, Andrew H S" sort="Lee, Andrew H S" uniqKey="Lee A" first="Andrew H S" last="Lee">Andrew H S. Lee</name>
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<name sortKey="Palacios, Jose" sort="Palacios, Jose" uniqKey="Palacios J" first="José" last="Palacios">José Palacios</name>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Pathology, Hospital Universitario Ramón y Cajal, Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid</wicri:regionArea>
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<settlement type="city">Madrid</settlement>
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<name sortKey="Richardson, Andrea L" sort="Richardson, Andrea L" uniqKey="Richardson A" first="Andrea L" last="Richardson">Andrea L. Richardson</name>
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<nlm:affiliation>Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Pathology, Brigham and Women's Hospital, Boston, MA</wicri:regionArea>
<placeName>
<region type="state">Massachusetts</region>
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<name sortKey="Vincent Salomon, Anne" sort="Vincent Salomon, Anne" uniqKey="Vincent Salomon A" first="Anne" last="Vincent-Salomon">Anne Vincent-Salomon</name>
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<nlm:affiliation>Department of Pathology, Institute Curie, Paris, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Pathology, Institute Curie, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
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<name sortKey="Schmitt, Fernando C" sort="Schmitt, Fernando C" uniqKey="Schmitt F" first="Fernando C" last="Schmitt">Fernando C. Schmitt</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Medicine and Pathology, Laboratoire National De Santé, Luxembourg, Luxembourg.</nlm:affiliation>
<country xml:lang="fr">Luxembourg (pays)</country>
<wicri:regionArea>Department of Medicine and Pathology, Laboratoire National De Santé, Luxembourg</wicri:regionArea>
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<name sortKey="Tan, Puay Hoon" sort="Tan, Puay Hoon" uniqKey="Tan P" first="Puay-Hoon" last="Tan">Puay-Hoon Tan</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Pathology, Singapore General Hospital, Singapore, Singapore.</nlm:affiliation>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Department of Pathology, Singapore General Hospital, Singapore</wicri:regionArea>
<wicri:noRegion>Singapore</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tse, Gary M" sort="Tse, Gary M" uniqKey="Tse G" first="Gary M" last="Tse">Gary M. Tse</name>
<affiliation wicri:level="4">
<nlm:affiliation>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.</nlm:affiliation>
<country xml:lang="fr">Hong Kong</country>
<wicri:regionArea>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin</wicri:regionArea>
<orgName type="university">Université chinoise de Hong Kong</orgName>
<placeName>
<settlement type="city">Sha Tin</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ellis, Ian O" sort="Ellis, Ian O" uniqKey="Ellis I" first="Ian O" last="Ellis">Ian O. Ellis</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
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<title level="j">Histopathology</title>
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<date when="2016" type="published">2016</date>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Breast (pathology)</term>
<term>Breast Neoplasms (pathology)</term>
<term>Carcinoma (pathology)</term>
<term>Carcinoma, Adenosquamous (pathology)</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Fibroma (pathology)</term>
<term>Humans</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Carcinome adénosquameux (anatomopathologie)</term>
<term>Carcinomes (anatomopathologie)</term>
<term>Diagnostic différentiel</term>
<term>Femelle</term>
<term>Fibrome (anatomopathologie)</term>
<term>Humains</term>
<term>Région mammaire (anatomopathologie)</term>
<term>Tumeurs du sein (anatomopathologie)</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr">
<term>Carcinome adénosquameux</term>
<term>Carcinomes</term>
<term>Fibrome</term>
<term>Région mammaire</term>
<term>Tumeurs du sein</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en">
<term>Breast</term>
<term>Breast Neoplasms</term>
<term>Carcinoma</term>
<term>Carcinoma, Adenosquamous</term>
<term>Fibroma</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Humans</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Diagnostic différentiel</term>
<term>Femelle</term>
<term>Humains</term>
</keywords>
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<front>
<div type="abstract" xml:lang="en">Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are classified traditionally into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey zone between benign and malignant, as their behaviour cannot be predicted reliably. Defined pathological categorization of such lesions is challenging, and for some entities is recognized to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over- or undertreatment. The rarity of these lesions makes the acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision-making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification and behaviour, and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential, such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions of uncertain malignant nature remain, such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of (1) breast lesions of uncertain malignant nature and (2) breast lesions of limited metastatic potential are proposed with details of which histological entities could be included in each category, and their management implications are discussed.</div>
</front>
</TEI>
<pubmed>
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<PMID Version="1">26348644</PMID>
<DateCreated>
<Year>2016</Year>
<Month>01</Month>
<Day>15</Day>
</DateCreated>
<DateCompleted>
<Year>2016</Year>
<Month>10</Month>
<Day>20</Day>
</DateCompleted>
<DateRevised>
<Year>2017</Year>
<Month>02</Month>
<Day>20</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Electronic">1365-2559</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>68</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2016</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Histopathology</Title>
<ISOAbbreviation>Histopathology</ISOAbbreviation>
</Journal>
<ArticleTitle>Breast lesions of uncertain malignant nature and limited metastatic potential: proposals to improve their recognition and clinical management.</ArticleTitle>
<Pagination>
<MedlinePgn>45-56</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1111/his.12861</ELocationID>
<Abstract>
<AbstractText>Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are classified traditionally into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey zone between benign and malignant, as their behaviour cannot be predicted reliably. Defined pathological categorization of such lesions is challenging, and for some entities is recognized to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over- or undertreatment. The rarity of these lesions makes the acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision-making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification and behaviour, and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential, such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions of uncertain malignant nature remain, such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of (1) breast lesions of uncertain malignant nature and (2) breast lesions of limited metastatic potential are proposed with details of which histological entities could be included in each category, and their management implications are discussed.</AbstractText>
<CopyrightInformation>© 2015 John Wiley & Sons Ltd.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Rakha</LastName>
<ForeName>Emad A</ForeName>
<Initials>EA</Initials>
<AffiliationInfo>
<Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Badve</LastName>
<ForeName>Sunil</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Departments of Pathology and Internal Medicine, Clarian Pathology Laboratory of Indiana University, Indianapolis, IN, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Eusebi</LastName>
<ForeName>Vincenzo</ForeName>
<Initials>V</Initials>
<AffiliationInfo>
<Affiliation>Sezione Anatomia Istologia e Citologia Patologica 'M. Malpighi', Università-ASL Ospedale Bellaria, Bologna, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Reis-Filho</LastName>
<ForeName>Jorge S</ForeName>
<Initials>JS</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fox</LastName>
<ForeName>Stephen B</ForeName>
<Initials>SB</Initials>
<AffiliationInfo>
<Affiliation>Pathology Department, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Dabbs</LastName>
<ForeName>David J</ForeName>
<Initials>DJ</Initials>
<AffiliationInfo>
<Affiliation>University of Pittsburgh Medical Center, Pittsburgh, PA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Decker</LastName>
<ForeName>Thomas</ForeName>
<Initials>T</Initials>
<AffiliationInfo>
<Affiliation>German Breast-Screening Program, Reference Centres Berlin and Muenster, Department of Pathology, Dietrich Bonhoeffer Medical Centre, Neubrandenburg, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hodi</LastName>
<ForeName>Zsolt</ForeName>
<Initials>Z</Initials>
<AffiliationInfo>
<Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ichihara</LastName>
<ForeName>Shu</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Nagoya Medical Center, Nagoya, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lee</LastName>
<ForeName>Andrew H S</ForeName>
<Initials>AH</Initials>
<AffiliationInfo>
<Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Palacios</LastName>
<ForeName>José</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Hospital Universitario Ramón y Cajal, Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Richardson</LastName>
<ForeName>Andrea L</ForeName>
<Initials>AL</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Vincent-Salomon</LastName>
<ForeName>Anne</ForeName>
<Initials>A</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Institute Curie, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Schmitt</LastName>
<ForeName>Fernando C</ForeName>
<Initials>FC</Initials>
<AffiliationInfo>
<Affiliation>Department of Medicine and Pathology, Laboratoire National De Santé, Luxembourg, Luxembourg.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Tan</LastName>
<ForeName>Puay-Hoon</ForeName>
<Initials>PH</Initials>
<AffiliationInfo>
<Affiliation>Department of Pathology, Singapore General Hospital, Singapore, Singapore.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Tse</LastName>
<ForeName>Gary M</ForeName>
<Initials>GM</Initials>
<AffiliationInfo>
<Affiliation>Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ellis</LastName>
<ForeName>Ian O</ForeName>
<Initials>IO</Initials>
<AffiliationInfo>
<Affiliation>Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y">
<Grant>
<GrantID>P30 CA008748</GrantID>
<Acronym>CA</Acronym>
<Agency>NCI NIH HHS</Agency>
<Country>United States</Country>
</Grant>
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<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
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<Country>England</Country>
<MedlineTA>Histopathology</MedlineTA>
<NlmUniqueID>7704136</NlmUniqueID>
<ISSNLinking>0309-0167</ISSNLinking>
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<CitationSubset>IM</CitationSubset>
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</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>Am J Surg Pathol. 1992 Sep;16(9):868-76</RefSource>
<PMID Version="1">1384377</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>Virchows Arch. 2005 Feb;446(2):142-9</RefSource>
<PMID Version="1">15583933</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>J Pathol. 2011 Aug;224(4):434-7</RefSource>
<PMID Version="1">21462188</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>Histopathology. 2014 Jul;65(1):9-23</RefSource>
<PMID Version="1">24382117</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>Arch Pathol Lab Med. 2015 Apr;139(4):552-7</RefSource>
<PMID Version="1">25822766</PMID>
</CommentsCorrections>
<CommentsCorrections RefType="Cites">
<RefSource>Ann Surg Oncol. 2012 Apr;19(4):1181-4</RefSource>
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