{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T19:32:19Z","timestamp":1784403139116,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Although evaluation of nuclear morphology is important for the diagnosis and categorisation of breast lesions, the criteria used to assess nuclear atypia rely upon the subjective evaluation of several features that may result in inter\u2010 and intraobserver variation. This study aims to refine the definitions of cytonuclear features in various breast lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>ImageJ was used to assess the nuclear morphological features including nuclear diameter, axis length, perimeter, area, circularity and roundness in 160 breast lesions comprising ductal carcinoma <jats:italic>in situ<\/jats:italic> (DCIS), invasive breast carcinoma of no special type (IBC\u2010NST), tubular carcinoma, usual ductal hyperplasia (UDH), columnar cell change (CCC) and flat epithelial atypia (FEA). Reference cells included normal epithelial cells, red blood cells (RBCs) and lymphocytes. Reference cells showed size differences not only between normal epithelial cells and RBCs but also between RBCs in varied\u2010sized blood vessels. Nottingham grade nuclear pleomorphism scores 1 and 3 cut\u2010offs in IBC\u2010NST, compared to normal epithelial cells, were &lt;\u2009\u00d71.2 and &gt;\u2009\u00d71.4 that of mean maximum Feret\u2019s diameter and &lt;\u2009\u00d71.6 and &gt;\u2009\u00d72.4 that of mean nuclear area, respectively. Nuclear morphometrics were significantly different in low\u2010grade IBC\u2010NST versus tubular carcinoma, low\u2010grade DCIS versus UDH and CCC versus FEA. No differences in the nuclear features between grade\u2010matched DCIS and IBC\u2010NST were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides a guide for the assessment of nuclear atypia in breast lesions, refines the comparison with reference cells and highlights the potential diagnostic value of image analysis tools in the era of digital pathology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14577","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T03:45:56Z","timestamp":1633405556000},"page":"515-528","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Nuclear morphology in breast lesions: refining its assessment to improve diagnostic concordance"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-158X","authenticated-orcid":false,"given":"Ayaka","family":"Katayama","sequence":"first","affiliation":[{"name":"Translational Medical Sciences Unit School of Medicine University of Nottingham City Hospital Nottingham UK"},{"name":"Diagnostic Pathology Gunma University Graduate School of Medicine Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Toss","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences Unit School of Medicine University of Nottingham City Hospital Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Parkin","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences Unit School of Medicine University of Nottingham City Hospital Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Sano","sequence":"additional","affiliation":[{"name":"Diagnostic Pathology Gunma University Graduate School of Medicine Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsunari","family":"Oyama","sequence":"additional","affiliation":[{"name":"Diagnostic Pathology Gunma University Graduate School of Medicine Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecily M","family":"Quinn","sequence":"additional","affiliation":[{"name":"Department of Histopathology St Vincent's University Hospital University College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian O","family":"Ellis","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences Unit School of Medicine University of Nottingham City Hospital Nottingham UK"},{"name":"Department of Histopathology Nottingham University Hospitals NHS 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