{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:59:28Z","timestamp":1791464368078,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Aims<\/jats:title>\n To evaluate the feasibility, appropriate relevance and impact on turnaround time (TAT) of an AI\u2010supported workflow in which AI, integrated in the Laboratory Information System (LIS) as well as in the daily workflow, autonomously triggers breast biomarker testing (ER, PR, HER2, Ki\u201067) for breast core needle biopsies with a high AI\u2010based likelihood of invasive breast cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods and results<\/jats:title>\n \n This retrospective, unicentric implementation study utilized an AI system (IBEX\u2122 Breast) to stratify H&E slides. For cases classified as \u2018high likelihood for invasive carcinoma\u2019, the LIS automatically ordered the standard biomarker panel (ER, PR, HER2 and Ki67), bypassing initial pathologist slide reading. The TAT was measured from the moment of the case assignment to both the availability of IHC staining (TAT\n tech<\/jats:sup>\n ) and the moment of reporting of the biomarkers (TAT\n clin<\/jats:sup>\n ). A pre\u2010implementation phase (December 2024\u2013May 2025; June 2024\u2013November 2025) was compared with a post\u2010implementation phase (June 2025\u2013November 2025). The appropriate relevance of the automated ordering was assessed by evaluating the AI\u2010initiated testing and the relevance of the ordered stains for the final diagnosis.\n <\/jats:p>\n \n Implementation of the AI\u2010enhanced workflow resulted in a statistically significant reduction in TAT\n tech<\/jats:sup>\n from approximately 32\u2009h to 23\u2009h, (\u221230%,\n P<\/jats:italic>\n \u2009<\u20090.01) and TAT\n clin<\/jats:sup>\n reduction of approximately 1 working day (\n P<\/jats:italic>\n \u2009\u2264\u20090.03) demonstrating that technical gains translate directly into faster biomarker reporting. Diagnostic accuracy was maintained throughout, with no unnecessary stains triggered by the system.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Integrated, LIS\u2010embedded AI in the daily workflow significantly optimizes breast cancer biomarker turnaround time without compromising the diagnostic process of a pathology laboratory. This demonstrates the transformative potential of AI to enhance laboratory efficiency and support more rapid patient\u2010centred oncologic care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/his.70181","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:22:01Z","timestamp":1779337321000},"page":"495-503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing breast core needle biopsy biomarker throughput using an\n AI<\/scp>\n \u2010based workflow"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6925-571X","authenticated-orcid":false,"given":"Frederik","family":"Deman","sequence":"first","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"},{"name":"Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences University of Ghent Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7543-8061","authenticated-orcid":false,"given":"Glenn","family":"Broeckx","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"},{"name":"Center for Brain Disease, Switch Lab, VIB\u2010KU Leuven Department of Cellular and Molecular Medicine KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Degotte","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-4660","authenticated-orcid":false,"given":"Vasiliki","family":"Siozopoulou","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"},{"name":"Centre for Oncological Research (CORE), MIPPRO, Faculty of Medicine Antwerp University Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"del Carmen Tavares","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Declercq","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1110-3801","authenticated-orcid":false,"given":"Roberto","family":"Salgado","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis aan de Stroom (ZAS) Antwerp Belgium"},{"name":"Division of Research Peter mac Callum Cancer Centre Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9900-7952","authenticated-orcid":false,"given":"Am\u00e9lie","family":"Dendooven","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences University of Ghent Ghent Belgium"},{"name":"Centre for Oncological Research (CORE), MIPPRO, Faculty of Medicine Antwerp University Antwerp Belgium"},{"name":"Department of Pathology University Hospital Ghent Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"466","article-title":"Anxiety in patients with symptomatic breast disease: effects of immediate versus delayed communication of results","volume":"78","author":"Ubhi SS","year":"1996","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2024-0316-CP"},{"key":"e_1_2_12_4_1","article-title":"Artificial intelligence and digital pathology: clinical promise and deployment considerations","volume":"10","author":"Zarella MD","year":"2023","journal-title":"J. Med. Imaging (Bellingham)"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12112794"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-021-03213-3"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-022-00496-w"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2025.105819"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13000-024-01453-w"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2022-0457-RA"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2025.100942"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.15481"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP8SKO6BUJQXHD"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2024.1766"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-021-00826-6"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2017-0139-OA"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpi.jpi_98_20"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010025\u201004372\u20103"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.70181","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/his.70181","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.70181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T19:41:31Z","timestamp":1785958891000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.70181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/his.70181"],"URL":"https:\/\/doi.org\/10.1111\/his.70181","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"2025-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}