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Biomarkers of the Tumor Microenvironment pp 207–243Cite as

Tumor Infiltrating Lymphocytes in Breast Cancer: Implementation of a New Histopathological Biomarker

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Abstract

In this chapter we describe a promising new histopathological biomarker in immuno-pathology/oncology: tumor infiltrating lymphocytes (TILs). The semiquantitative assessment of TILs in breast cancer (and other tumors) is a well-defined histopathological parameter of which the assessment can easily be integrated in the standard examination of biopsies and resection specimens by the (surgical) pathologist. Focusing on breast cancer, we first summarize available evidence on the prognostic and predictive value of TILs in DCIS, ER+/HER2-, triple-negative, and Her2-positive breast cancer. We also describe the correlation between TILs and other biomarkers, the most notorious among pathologists being programmed death-ligand 1 (PD-L1).

Secondly, we describe the efforts of the International Immuno-Oncology Biomarkers Working Group (www.tilsinbreastcancer.org) to standardize TIL assessment (leading to standardized international guidelines), create awareness, and educate pathologists and oncologists. Finally, we briefly introduce new concepts and techniques that will in the coming years be introduced to further characterize the immune microenvironment in tumors and the interaction between tumor cells and inflammatory cells, such as the use of spatial single cell technologies and artificial intelligence. We believe these techniques should be integrated with the use of TILs and other biomarkers in clinical practice, for the benefit of our patients.

Key Content Graphic. Figure created with BioRender.com

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Authors and Affiliations

  1. Department of Imaging and Pathology, KU Leuven, Translational Cell and Tissue Research Unit, Leuven, Belgium

    Giuseppe Floris & Asier Antoranz

  2. Department of Pathology, University Hospitals Leuven, Leuven, Belgium

    Giuseppe Floris & Maxim De Schepper

  3. Department of Histopathology, Antwerp University Hospital, Edegem, Belgium

    Glenn Broeckx

  4. Department of Oncology, Laboratory for Translational Breast Cancer Research, KU Leuven, Leuven, Belgium

    Maxim De Schepper & Christine Desmedt

  5. Laboratory of Pathology and Cytology PA2, GZA/ZNA Hospitals, Antwerp, Belgium

    Roberto Salgado & Gert G. G. M. Van den Eynden

  6. Histopathology, Imaging and Quantification Unit, CellCarta, Antwerp, Belgium

    Dieter J. E. Peeters

  7. Laboratory of Pathology, AZ Sint-Maarten, Mechelen, Belgium

    Dieter J. E. Peeters

  8. Human Molecular Genetics, University of Antwerp, Edegem, Belgium

    Dieter J. E. Peeters

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  1. Centre for Cancer Biomarkers CCBIO Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Lars A. Akslen

  2. Department of Surgery, Harvard Medical School, Vascular Biology Program, Boston Children’s Hospital, Boston, USA

    Randolph S. Watnick

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Floris, G. et al. (2022). Tumor Infiltrating Lymphocytes in Breast Cancer: Implementation of a New Histopathological Biomarker. In: Akslen, L.A., Watnick, R.S. (eds) Biomarkers of the Tumor Microenvironment. Springer, Cham. https://doi.org/10.1007/978-3-030-98950-7_13

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