Breast Cancer

, Volume 23, Issue 3, pp 391–399 | Cite as

The Japanese Breast Cancer Society clinical practice guidelines for pathological diagnosis of breast cancer, 2015 edition

  • Rie HoriiEmail author
  • Naoko Honma
  • Akiko Ogiya
  • Yuji Kozuka
  • Kazuya Yoshida
  • Masayuki Yoshida
  • Shin-ichiro Horiguchi
  • Yoshinori Ito
  • Hirofumi Mukai
Special Feature Japanese Breast Cancer Society Guidelines 2015


The Japanese Breast Cancer Society (JBCS) Clinical Practice Guidelines were published in Japanese by Kanehara & Co., Ltd in July 2015. This article is an English digest of the guidelines for pathological diagnosis. These guidelines are updated every 2 years. In the 2015 edition, clinical questions regarding Ki67 and cell blocks were newly incorporated. All other content was reviewed and amended based on the current literature.

Guidelines for pathological diagnosis

CQ1: Is fine needle aspiration cytology (FNAC) recommended as a diagnostic procedure for breast lesions or axillary lymph node metastasis?


  1. 1.

    FNAC is recommended as a diagnostic procedure for breast lesions (Grade B).

  2. 2.

    FNAC for axillary lymph nodes should be performed taking into account the sampling failure and difficulty of identifying nodal disease burden (Grade C1).


CQ2: Is core needle biopsy (CNB) recommended as a diagnostic procedure for breast lesions?


CNB is...


Invasive Breast Cancer Core Needle Biopsy Fine Needle Aspiration Cytology Japanese Breast Cancer Society Histological Therapeutic Effect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards

Conflict of interest

Yoshinori Ito received lecture frees from Chugai, Esai and Novartis. He also received research Grants from Novartis, Chugai, Parexel, Esai, Sanofi, Taiho, EPS, Dai-ichi-sankyo and Boehringer-ingelheim. The other authors declare that they have no conflict of interest.


  1. 1.
    Pisano ED, Fajardo LL, Caudry DJ, Sneige N, Frable WJ, Berf WA, et al. Fine-needle aspiration biopsy of non-palpable breast lesions in a multicenter clinical trial: results from the radiologic oncology group V. Radiology. 2001;219:785–92.CrossRefPubMedGoogle Scholar
  2. 2.
    Giard RW, Hermans J. The value of routine cytologic examination of breast cyst fluids. Acta Cytol. 1987;31:301–4.Google Scholar
  3. 3.
    Yamaguchi R, Tsuchiya SI, Koshikawa T, Ishikawa A, Nasuda S, Maeda I, et al. Diagnostic accuracy of fine-needle aspiration cytology of the breast in Japan: report from the Working Group on the Accuracy of Breast Fine-Needle Aspiration Cytology of the Japanese Society of Clinical Cytology. Oncol Rep. 2012;28:1606–12.PubMedGoogle Scholar
  4. 4.
    Westenend PJ, Sever AR, Beekman-De Volderr HJ, Liem SJ. A comparison of aspiration cytology and core needle biopsy in the evaluation of breast lesions. Cancer. 2001;93:146–50.CrossRefPubMedGoogle Scholar
  5. 5.
    Hatada T, Ishii H, Ichii S, Okada K, Fujikawa Y, Yamamura T. Diagnostic value of ultrasound-guided fine-needle aspiration biopsy, core-needle biopsy, and evaluation of combined use in the diagnosis of breast lesions. J Am Coll Surg. 2000;190:299–303.CrossRefPubMedGoogle Scholar
  6. 6.
    Ballo MS, Sneige N. Can cone needle biopsy replace fine-needle aspiration cytology in the diagnosis of palpable breast carcinoma? A comparative study of 124 women. Cancer. 1996;78:773–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Pijnappel RM, van den Donk M, Holland R, Mali WP, Peterse JL, Hendrinks JH, et al. Diagnostic accuracy for different strategies of image-guided breast intervention in cases of nonpalpable breast lesions. Br J Cancer. 2004;90:595–600.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Feoli F, Paesmans M, Van Eeckhout P. Fine needle aspiration cytology of the breast: impact of experience on accuracy, using standardized cytologic criteria. Acta Cytol. 2008;52:145–51.CrossRefPubMedGoogle Scholar
  9. 9.
    Boland MR, Prichard RS, Daskalova I, Lowery AJ, Evoy D, Geraghty J, et al. Axillary nodal burden in primary breast cancer patients with positive pre-operative ultrasound guided fine needle aspiration cytology: management in the era of ACOSOG Z011. Eur J Surg Oncol. 2015;41:559–65.CrossRefPubMedGoogle Scholar
  10. 10.
    Gumus H, Gumus M, Devalia H, Mills P, Fish D, Jones P, et al. Causes of failure in removing calcium in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy. Diagn Interv Radiol. 2012;18:354–9.PubMedGoogle Scholar
  11. 11.
    Penco S, Rizzo S, Bozzini AC, Latronico A, Menna S, Cassano E, et al. Stereotactic vacuum-assisted breast biopsy is not a therapeutic procedure even when all mammmographically found calcification are removed: analysis of 4,086 procedures. AJR Am J Roentgenol. 2010;195:1255–60.CrossRefPubMedGoogle Scholar
  12. 12.
    Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957;11:359–77.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19:403–10.CrossRefPubMedGoogle Scholar
  14. 14.
    Tsuda H, Akiyama F, Kurosumi M, Sakamoto G, Watanabe T. Establishment of histological criteria for high-risk node-negative breast carcinoma for a multi-institutional randomized clinical trial of adjuvant therapy. Japan National Surgical Adjuvant Study of Breast Cancer (NSAS-BC) Pathology Section. Jpn J Clin Oncol. 1998;28:486–91.CrossRefPubMedGoogle Scholar
  15. 15.
    Dowsett M, Nielsen TO, A’Hern R, Bartlett J, Coombes RC, Cuzick J, Internationa Ki-67 in Breast Cancer Working Group, et al. Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst. 2011;103:1656–64.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Synnestvedt M, Borgen E, Russnes HG, Kumar NT, Schlichting E, Giercksky KE, et al. Combined analysis of vascular invasion, grade, HER2 and Ki67 expression identifies early breast cancer patients with questionable benefit of systemic adjuvant therapy. Acta Oncol. 2013;52(1):91–101.CrossRefPubMedGoogle Scholar
  17. 17.
    Bjerre C, Knoop A, Bjerre K, Larsen MS, Henriksen KL, Lyng MB, et al. Association of tissue inhibitor of metalloproteinases-1 and Ki67 in estrogen receptor positive breast cancer. Acta Oncol. 2013;52(1):82–90.CrossRefPubMedGoogle Scholar
  18. 18.
    Stuart-Harris R, Caldas C, Pinder SE, Pharoah P. Proliferation markers and survival in early breast cancer: a systemic review and meta-analysis of 85 studies in 32,825 patients. Breast. 2008;17(4):323–34.CrossRefPubMedGoogle Scholar
  19. 19.
    Hugh J, Hanson J, Cheang MC, Nielsen TO, Perou CM, Dumontet C, et al. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 trial. J Clin Oncol. 2009;27(8):1168–76.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Penault-Llorca F, André F, Sagan C, Lacroix-Triki M, Denoux Y, Verriele V, et al. Ki67 expression and docetaxel efficacy in patients with estrogen receptor-positive breast cancer. J Clin Oncol. 2009;27(17):2809–15.CrossRefPubMedGoogle Scholar
  21. 21.
    Viale G, Regan MM, Mastropasqua MG, Maffini F, Maiorano E, Colleoni M, et al. International Breast Cancer Study Group. Predictive value of tumor Ki-67 expression in two randomized trials of adjuvant chemoendocrine therapy for node-negative breast cancer. J Natl Cancer Inst. 2008;100(3):207–12.CrossRefPubMedGoogle Scholar
  22. 22.
    Fasching PA, Heusinger K, Haeberle L, Niklos M, Hein A, Bayer CM, et al. Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment. BMC Cancer. 2011;11:486.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    von Minckwitz G, Sinn HP, Raab G, Loibl S, Blohmer JU, Eidtmann H, Hilfrich J, et al. German Breast Group. Clinical response after two cycles compared to HER2, Ki-67, p53, and bcl-2 in independently predicting a pathological complete response after preoperative chemotherapy in patients with operable carcinoma of the breast. Breast Cancer Res. 2008;10(2):R30.CrossRefGoogle Scholar
  24. 24.
    Jones RL, Salter J, A’Hern R, Nerurkar A, Parton M, Reis-Filho JS, et al. Relationship between oestrogen receptor status and proliferation in predicting response and long-term outcome to neoadjuvant chemotherapy for breast cancer. Breast Cancer Res Treat. 2010;119(2):315–23.CrossRefPubMedGoogle Scholar
  25. 25.
    Guarneri V, Piacentini F, Ficarra G, Frassoldati A, D’Amico R, Giovannelli S, et al. A prognostic model based on nodal status and Ki-67 predicts the risk of recurrence and death in breast cancer patients with residual disease after preoperative chemotherapy. Ann Oncol. 2009;20(7):1193–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Wolmark N, Wang J, Mamounas E, Bryant J, Fisher B. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr. 2001;30:96–102.CrossRefPubMedGoogle Scholar
  27. 27.
    Van der Hage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19:4224–37.PubMedGoogle Scholar
  28. 28.
    Bear HD, Anderson S, Smith RE, Geyer CE Jr, Mamounas EP, Fisher B, et al. Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2006;24:2019–27.CrossRefPubMedGoogle Scholar
  29. 29.
    Sahoo S, Lester SC. Pathology of breast carcinomas after neoadjuvant chemotherapy: an overview with recommendations on specimen processing and reporting. Arch Patholo Lab Med. 2009;133:633–42.Google Scholar
  30. 30.
    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomized trials. Lancet. 2011;378:771–84.CrossRefGoogle Scholar
  31. 31.
    Fisher B, Anderson S, Tan-Chiu E, Wolmark N, Wickerham DL, Fisher ER, et al. Tamoxifen and chemotherapy for axillary node-negative, estrogen receptor-negative breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-23. J Clin Oncol. 2001;19:931–42.PubMedGoogle Scholar
  32. 32.
    Prat A, Cheang MC, Martín M, Parker JS, Carrasco E, Caballero R, et al. Prognostic significance of progesterone receptor-positive tumor cells within immunohistochemically defined luminal A breast cancer. J Clin Oncol. 2013;31(2):203–9.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Allred DC, Anderson SJ, Paik S, Wickerham DL, Nagtegaal ID, Swain SM, et al. Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NASBP protocol B-24. J Clin Oncol. 2012;30:1268–73.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Endo Y, Toyama T, Takahashi S, Sugiura H, Yoshimoto N, Iwasa M, et al. High estrogen receptor expression and low Ki67 expression are associated with improved time to progression during first-line endocrine therapy with aromatase inhibitors in breast cancer. Int J Clin Oncol. 2011;16:512–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Yamashita H, Yando Y, Nishio M, Zhang Z, Hamaguchi M, Mita K, et al. Immunohistochemical evaluation of hormone receptor status for predicting response to endocrine therapy in metastatic breast cancer. Breast Cancer. 2006;13:74–83.CrossRefPubMedGoogle Scholar
  36. 36.
    Barnes DM, Harris WH, Smith P, Millis RR, Rubens RD. Immunohistochemical determination of oestrogen receptor: comparison of different methods of assessment of staining and correlation with clinical outcome of breast cancer patients. Br J Cancer. 1996;74(9):1445–51.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Harvey JM, Clark GM, Osborne CK, Allred DC. Estrogen receptor status by immunohistochemistry is superior to the ligand—binding assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 1999;17(5):1474–81.PubMedGoogle Scholar
  38. 38.
    Ogawa Y, Moriya T, Kato Y, Oguma M, Ikeda K, Takashima T, et al. Immunohistochemical assessment for estrogen receptor and progesterone receptor status in breast cancer: analysis for a cut—off point as the predictor for endocrine therapy. Breast Cancer. 2004;11(3):267–75.CrossRefPubMedGoogle Scholar
  39. 39.
    Horii R, Akiyama F, Ito Y, Iwase T. Assessment of hormone receptor status in breast cancer. Pathol Int. 2007;57(12):784–90.CrossRefPubMedGoogle Scholar
  40. 40.
    Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, American Society of Clinical Oncology, College of American Pathologists, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch Pathol Lab Med. 2010;134(7):e48–72.PubMedGoogle Scholar
  41. 41.
    Leake R, Barnes D, Pinder S, Ellis I, Anderson L, Anderson T, et al. Immunohistochemical detection of steroid receptors in breast cancer: a working protocol. UK Receptor Group, UK NEQAS, The Scottish Breast Cancer Pathology Group, and The Receptor and Biomarker Study Group of the EORTC. J Clin Pathol. 2000;53(8):634—5.Google Scholar
  42. 42.
    Umemura S, Kurosumi M, Moriya T, Oyama T, Arihiro K, Yamashita H, et al. Immunohistochemical evaluation for hormone receptors in breast cancer: a practically useful evaluation system and handling protocol. Breast Cancer. 2006;13(3):232–5.CrossRefPubMedGoogle Scholar
  43. 43.
    Honma N, Horii R, Iwase T, Saji S, Younes M, Ito Y, et al. Proportion of estrogen or progesterone receptor expressing cells in breast cancers and response to endocrine therapy. Breast. 2014;23(6):754–62.CrossRefPubMedGoogle Scholar
  44. 44.
    Arteaga CL, Sliwkowski MX, Osborne CK, Perez EA, Puglisi F, Gianni L. Treatment of HER2-positive breast cancer: current status and future perspectives. Nat Rev Clin Oncol. 2011;9:16–32.CrossRefPubMedGoogle Scholar
  45. 45.
    Guarneri V, Barbieri E, Dieci MV, Piacentini F, Conte P. Anti-HER2 neoadjuvant and adjuvant therapies in HER2 positive breast cancer. Cancer Treat Rev. 2010;36(Suppl 3):S62–6.CrossRefPubMedGoogle Scholar
  46. 46.
    Niikura N, Liu J, Hayashi N, Mittendorf EA, Gong Y, Palla SL, et al. Loss of human epidermal growth factor receptor 2 (HER2) expression in metastatic site of HER2-overexpressing primary breast tumors. J Clin Oncol. 2012;30:593–9.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Fabi A, Di Benedetto A, Metro G, Perracchio L, Nistico C, Di Filippo F, et al. HER2 protein and gene variation between primary and metastatic breast cancer: significance and impact on patient care. Clin Cancer Res. 2011;17:2055–64.CrossRefPubMedGoogle Scholar
  48. 48.
    Bast RC Jr, Ravdin P, Hayes DF, Bates S, Fritsche H Jr, Jessup JM, et al. American Society of Clinical Oncology Tumor Markers Expert Panel. 2000 update of recommendations for the use of tumor markers in breast and colorectal cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19(6):1865–78.PubMedGoogle Scholar
  49. 49.
    Tong LC, Nelson N, Tsourigiannis J, Mulligan AM. The effect of prolonged fixation on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast cancer: a prospective study. Am J Surg Pathol. 2011;35(4):545–52.CrossRefPubMedGoogle Scholar
  50. 50.
    Wolf AC, Hammond EH, Hicks DG, Dowsett M, McShane LM, Allison KM, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice guideline update. J Clin Oncol. 2013;31(31):3997–4014.CrossRefGoogle Scholar
  51. 51.
    Penault-Llorca F, Bilous M, Dowsett M, Hanna W, Osamura RY, Rüschoff J, et al. Emerging technologies for assessing HER2 amplification. Am J Clin Pathol. 2009;132:539–48.CrossRefPubMedGoogle Scholar
  52. 52.
    Horii R, Matsuura M, Iwase T, Ito Y, Akiyama F. Comparison of dual-color in situ hybridization in HER2 gene amplification in breast cancer. Breast Cancer. 2014;21:598–604.CrossRefPubMedGoogle Scholar
  53. 53.
    Lebeau A, Turzynski A, Braun S, Behrhof W, Fleige B, Schmitt WD, et al. Reliability of human epidermal growth factor receptor 2 immunohistochemistry in breast core needle biopsies. J Clin Oncol. 2010;28:3264–70.CrossRefPubMedGoogle Scholar
  54. 54.
    Chen X, Yuan Y, Gu Z, Shen K. Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat. 2012;134:957–67.CrossRefPubMedGoogle Scholar
  55. 55.
    Li S, Yang X, Zhang Y, Fan L, Zhang F, Chen L, et al. Assessment accuracy of core needle biopsy for hormone receptors in breast cancer: a meta-analysis. Breast Cancer Res Treat. 2012;135:325–34.CrossRefPubMedGoogle Scholar
  56. 56.
    van de Ven S, Smit VT, Dekker TJ, Nortier JW, Kroep JR. Discordances in ER, PR and HER2 receptors after neoadjuvant chemotherapy in breast cancer. Cancer Treat Rev. 2011;37:422–30.PubMedGoogle Scholar
  57. 57.
    Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.CrossRefPubMedGoogle Scholar
  58. 58.
    Silverstein MJ, Lagios MD, Craig PH, Waisman JP, Lewinsky BS, Colburn WJ, et al. A prognostic index for ductal carcinoma in situ of the breast. Cancer. 1996;77:2267–74.CrossRefPubMedGoogle Scholar
  59. 59.
    Houssami N, Macaskill P, Marinovich ML, Dixon JM, Irwig L, Brennan ME, et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer. 2010;46:3219–32.CrossRefPubMedGoogle Scholar
  60. 60.
    Singletary SE. Surgical margin in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg. 2002;184:383–93.CrossRefPubMedGoogle Scholar
  61. 61.
    Fukamachi K, Ishida T, Usami S, Takeda M, Watanabe M, Sasano H, et al. Total-circumference intraoperative frozen section analysis reduced margin-positive rate in breast-conservation surgery. Jpn J Clin Oncol. 2010;40:513–20.CrossRefPubMedGoogle Scholar
  62. 62.
    Esbona K, Li Z, Willke LG. Intraoperative imprint cytology and frozen section pathology for margin assessment in breast conservation surgery: a systemic review. Ann Surg Oncol. 2012;19:3236–45.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Lyman GH, Giuliano AE, Somerfield MR, Benson AB, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.CrossRefPubMedGoogle Scholar
  64. 64.
    UICC International Union Against Cancer TNM Classification of Malignant Tumours, 7th edition. 2009. Wiley-Blackwell.Google Scholar
  65. 65.
    Tsujimoto M, Nakabayashi K, Yoshidome K, Kaneko T, Iwase T, Akiyama F, et al. One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res. 2007;13:4807–16.CrossRefPubMedGoogle Scholar
  66. 66.
    Giuliano AE, Hawes D, Ballman KV, Whitworth PW, Blumencranz PW, Reintgen DS, et al. Association of occult metastases in sentinel lymph nodes and bone marrow with survival among women with early-stage invasive breast cancer. JAMA. 2001;306:385–93.CrossRefGoogle Scholar
  67. 67.
    Shabaik A, Lin G, Peterson M, Hasteh F, Tipps A, Datnow B, et al. Reliability of Her2/neu, estrogen receptor, and progesterone receptor testing by immunohistochemistry on cell block of FNA and serous effusions from patients with primary and metastatic breast carcinoma. Diag cytopathol. 2011;39:328–32.CrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2016

Authors and Affiliations

  • Rie Horii
    • 1
    Email author
  • Naoko Honma
    • 2
  • Akiko Ogiya
    • 3
  • Yuji Kozuka
    • 4
  • Kazuya Yoshida
    • 5
  • Masayuki Yoshida
    • 6
  • Shin-ichiro Horiguchi
    • 7
  • Yoshinori Ito
    • 8
  • Hirofumi Mukai
    • 9
  1. 1.Department of PathologyCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Department of Pathology, School of MedicineToho UniversityTokyoJapan
  3. 3.Breast Surgical OncologyBreast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  4. 4.Department of PathologyMie University HospitalMieJapan
  5. 5.Breast Center, Northern Fukushima Medical CenterFukushimaJapan
  6. 6.Department of PathologyNational Cancer Center HospitalTokyoJapan
  7. 7.Department of PathologyTokyo Metropolitan Cancer and Infectious disease Center Komagome HospitalTokyoJapan
  8. 8.Breast Medical Oncology, Breast Oncology CenterCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan
  9. 9.Department of Breast and Medical OncologyNational Cancer Center Hospital EastChibaJapan

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