Evaluation and Reporting of Breast Cancer after Neoadjuvant Chemotherapy

ABSTRACT

Neoadjuvant chemotherapy (NAC) applied prior to surgical excision of the tumor has become a frequently used therapeutic approach in patients with operable and inoperable breast cancer. Such chemotherapy alters the morphology of breast cancers and normal breast tissue. Thus it is important for pathologists to become familiar with these changes and to know how to handle and assess breast specimens after neoadjuvant chemotherapy. Evaluation of the therapeutic response and measurement of residual disease is important in the pathologic assessment of the final surgical resection specimens because these data help in predicting patient's chances for cure and survival, and also provide guidance for further therapy. This review will discuss treatment effects and demonstrate how to evaluate, sample and measure residual breast cancer in excision specimens including axillary lymph nodes.

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