Standardization of the tumor-stroma ratio scoring method for breast cancer research

Hagenaars, Sophie C; Vangangelt, Kiki M H; Van Pelt, Gabi W; Karancsi, Zsófia; Tollenaar, Rob A E M; Green, Andrew R; Rakha, Emad A; Kulka, Janina; Mesker, Wilma E

Abstract

Purpose: The tumor-stroma ratio (TSR) has repeatedly proven to be correlated with patient outcomes in breast cancer using large retrospective cohorts. However, studies validating the TSR often show variability in methodology, thereby hampering comparisons and uniform outcomes. Method: This paper provides a detailed description of a simple and uniform TSR scoring method using Hematoxylin and Eosin (H&E)-stained core biopsies and resection tissue, specifically focused on breast cancer. Possible histological challenges that can be encountered during scoring including suggestions to overcome them are reported. Moreover, the procedure for TSR estimation in lymph nodes, scoring on digital images and the automatic assessment of the TSR using artificial intelligence are described. Conclusion: Digitized scoring of tumor biopsies and resection material offers interesting future perspectives to determine patient prognosis and response to therapy. The fact that the TSR method is relatively easy, quick, and cheap, offers great potential for its implementation in routine diagnostics, but this requires high quality validation studies.

Citation

Hagenaars, S. C., Vangangelt, K. M. H., Van Pelt, G. W., Karancsi, Z., Tollenaar, R. A. E. M., Green, A. R., …Mesker, W. E. (2022). Standardization of the tumor-stroma ratio scoring method for breast cancer research. Breast Cancer Research and Treatment, 193, 545-553. https://doi.org/10.1007/s10549-022-06587-3

• Journal Article Type: Review
• Acceptance Date: Mar 29, 2022
• Online Publication Date: Apr 16, 2022
• Publication Date: 2022-06
• Deposit Date: Apr 5, 2022
• Publicly Available Date: Apr 21, 2022
• Journal: Breast Cancer Research and Treatment
• Print ISSN: 0167-6806
• Electronic ISSN: 1573-7217
• Publisher: Springer Science and Business Media LLC
• Peer Reviewed: Peer Reviewed
• Volume: 193
• Pages: 545-553
• DOI: https://doi.org/10.1007/s10549-022-06587-3
• Keywords: Cancer Research; Oncology
• Public URL: https://nottingham-repository.worktribe.com/output/7708252
• Publisher URL: https://link.springer.com/article/10.1007/s10549-022-06587-3