» Articles » PMID: 25214542

The Evaluation of Tumor-infiltrating Lymphocytes (TILs) in Breast Cancer: Recommendations by an International TILs Working Group 2014

Abstract

Background: The morphological evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer (BC) is gaining momentum as evidence strengthens for the clinical relevance of this immunological biomarker. Accumulating evidence suggests that the extent of lymphocytic infiltration in tumor tissue can be assessed as a major parameter by evaluation of hematoxylin and eosin (H&E)-stained tumor sections. TILs have been shown to provide prognostic and potentially predictive value, particularly in triple-negative and human epidermal growth factor receptor 2-overexpressing BC.

Design: A standardized methodology for evaluating TILs is now needed as a prerequisite for integrating this parameter in standard histopathological practice, in a research setting as well as in clinical trials. This article reviews current data on the clinical validity and utility of TILs in BC in an effort to foster better knowledge and insight in this rapidly evolving field, and to develop a standardized methodology for visual assessment on H&E sections, acknowledging the future potential of molecular/multiplexed approaches.

Conclusions: The methodology provided is sufficiently detailed to offer a uniformly applied, pragmatic starting point and improve consistency and reproducibility in the measurement of TILs for future studies.

Citing Articles

Molecular subtyping and target identification in triple negative breast cancer through immunohistochemistry biomarkers.

Bouzid R, Bouzid R, Labed H, Serhani I, Hellal D, Oumeddour L BMC Cancer. 2025; 25(1):454.

PMID: 40082760 PMC: 11905517. DOI: 10.1186/s12885-025-13832-7.


Population-specific patterns in assessing molecular subtypes of young black females with triple-negative breast cancer.

Rajagopal P, Reid S, Fan R, Venton L, Weidner A, Roberson M NPJ Breast Cancer. 2025; 11(1):28.

PMID: 40069179 PMC: 11897140. DOI: 10.1038/s41523-025-00731-0.


Therapeutic potential of triple-negative breast cancer immune checkpoint blockers: A 21-year bibliometric analysis.

Sun Z, Liu C, Yao Y, Gao C, Li H, Wang L Medicine (Baltimore). 2025; 104(10):e41739.

PMID: 40068043 PMC: 11903016. DOI: 10.1097/MD.0000000000041739.


Automated deep learning-based assessment of tumour-infiltrating lymphocyte density determines prognosis in colorectal cancer.

Millward J, He Z, Nibali A, Mouradov D, Mielke L, Tran K J Transl Med. 2025; 23(1):298.

PMID: 40065354 PMC: 11892243. DOI: 10.1186/s12967-025-06254-3.


PTEN inactivating mutations are associated with hormone receptor loss during breast cancer recurrence.

Zhan H, Antony V, Tang H, Theriot J, Liang Y, Hui P Breast Cancer Res Treat. 2025; .

PMID: 40063317 DOI: 10.1007/s10549-025-07660-3.


References
1.
Qi W, Huang X, Wang J . Correlation between Th17 cells and tumor microenvironment. Cell Immunol. 2013; 285(1-2):18-22. DOI: 10.1016/j.cellimm.2013.06.001. View

2.
Gobert M, Treilleux I, Bendriss-Vermare N, Bachelot T, Goddard-Leon S, Arfi V . Regulatory T cells recruited through CCL22/CCR4 are selectively activated in lymphoid infiltrates surrounding primary breast tumors and lead to an adverse clinical outcome. Cancer Res. 2009; 69(5):2000-9. DOI: 10.1158/0008-5472.CAN-08-2360. View

3.
Bates G, Fox S, Han C, Leek R, Garcia J, Harris A . Quantification of regulatory T cells enables the identification of high-risk breast cancer patients and those at risk of late relapse. J Clin Oncol. 2006; 24(34):5373-80. DOI: 10.1200/JCO.2006.05.9584. View

4.
Loi S, Michiels S, Salgado R, Sirtaine N, Jose V, Fumagalli D . Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. Ann Oncol. 2014; 25(8):1544-50. DOI: 10.1093/annonc/mdu112. View

5.
Demaria S, Volm M, Shapiro R, Yee H, Oratz R, Formenti S . Development of tumor-infiltrating lymphocytes in breast cancer after neoadjuvant paclitaxel chemotherapy. Clin Cancer Res. 2001; 7(10):3025-30. View