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The University of Michigan Comprehensive Cancer Center

Hepatobiliary cancers are common worldwide and highly lethal. Hepatocellular carcinoma is the most common hepatobiliary malignancy and the seventh most common cancer worldwide. Gallbladder cancer is the most common biliary tract malignancy, accounting for approximately 5000 newly diagnosed cases in the United States. Cholangiocarcinomas are diagnosed throughout the biliary tree and are usually classified as intrahepatic or extrahepatic. Intrahepatic cholangiocarcinomas arise from intrahepatic small-duct radicals, whereas extrahepatic cholangiocarcinomas encompass hilar carcinomas (including Klatskin's tumors). These guidelines discuss these subtypes of hepatobiliary cancer and the epidemiology, pathology, etiology, staging, diagnosis, and treatment of each subtype.

For the most recent version of the guidelines, please visit NCCN.org

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Robert W. Carlson, Susan J. Moench, M. Elizabeth H. Hammond, Edith A. Perez, Harold J. Burstein, D. Craig Allred, Charles L. Vogel, Lori J. Goldstein, George Somlo, William J. Gradishar, Clifford A. Hudis, Mohammad Jahanzeb, Azadeh Stark, Antonio C. Wolff, Michael F. Press, Eric P. Winer, Soonmyung Paik, Britt-Marie Ljung, and for the NCCN HER2 Testing in Breast Cancer Task Force

the NCCN Breast Cancer Clinical Practice Guidelines Panel. 10 Additionally, breast cancer experts with special expertise in HER2 biology, testing, or trastuzumab were invited. In all, 24 Task Force members represented medical oncology, pathology

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Holly Dushkin and Massimo Cristofanilli

Inflammatory breast cancer (IBC) represents the most virulent form of breast cancer, characterized by involvement of the skin and rapid progression of the disease. Management involves careful coordination of multidisciplinary modalities, including imaging, systemic chemotherapy, surgery, and radiation therapy. The use of neoadjuvant chemotherapy has contributed significantly to improvement in overall survival since the first descriptions of this entity, and has made the role of locoregional therapy, including surgery and radiation, critical to continued improvements in this disease. This article examines the unique epidemiology and pathology of IBC, and reviews the various treatment modalities, noting the significance of a multimodality approach and delineating each of the specific components. Moreover, the current research in IBC is briefly described, which experts hope will further improve systemic therapies.

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Harold J. Burstein

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Robert L. Coleman, Michael Frumovitz, and Charles F. Levenback

Lymphatic mapping and sentinel node identification are rapidly becoming the standard of care in managing many malignancies. These procedures have allowed focused evaluation of relevant regional lymphatics, which has led not only to improved precision of nodal pathology, but also to treatment triage and the potential for reduced postoperative morbidity. Given its clinical potential, new cancer primary sites are being evaluated, including those of the female genital tract. Of these, carcinoma of the vulva seems the most apposite; however, it is a rare malignancy and therefore large randomized treatment trials based on sentinel node triage are difficult to perform. Cancers of the uterus–cervix and corpus are more common. Because the physiologic lymphatic drainage from this organ is ambiguous, principle lymphatic basins are located in many different anatomic locales, making sentinel node identification precarious, yet highly relevant and informative. Current experience in carcinoma of the cervix suggests the concept is feasible. A consensus in corpus cancer has not been reached, although both sites are of keen interest with the increasing use of laparoscopy in surgical management. Prospective multi-institutional validation studies are underway.

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Neha Verma, Manisha Shah, Luma Ghalib, Lawrence Kirschner, Mayumi Endo, and Bhavana Konda

syndrome she underwent resection of this lesion. Pathology revealed a 1.5cm atypical lung carcinoid with Ki67 <5%. Case 2: A 33-year-old woman presented with new onset of facial acne, hirsutism, worsening muscle weakness, and workup was consistent with

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Mary K. Hayes, Mayra Frau, Erica Bloomquist, and Heather Wright

surgery based on the intraoperative pathology of the excised LN. An excellent response post-NACT with a “normalized” BX LN is often poorly visualized and limits LN LOC to 72% success rate. Therefore, a clinical practice of LN BX and up front WFL, when the

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Tara M. Breslin, Marcy Waldinger, and Samuel M. Silver

; pathology; and radiology. The mission of the BCTF is to implement evidence-based evaluation and management strategies for patient care at the UMCCC Breast Care Center. The results were then shared at the Breast Care Center Educational Forum with the entire

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Saman S. Karimi and Dr. Maria F. Gonzalez

Introduction: Efficiency and adequacy in reporting diagnoses and molecular alterations in surgical pathology specimens have a direct impact on patient care. We conducted a retrospective study to assess the turnaround time (TAT) of rectal specimens

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Margaret Tempero

, which now has approval for its CDx diagnostic test. I've been pretty public about my endorsement of FDA approval of diagnostics. 1 Not everyone agrees with this position, though, especially pathology groups who, in their defense, have made big