Pathological assessment of breast carcinoma specimens undergoing neoadjuvant chemotherapy

Abstract: Breast Carcinoma (BC) is the frequent type of diagnosed cancers in females. Objective: To determine the pathological assessment of breast carcinoma specimens undergoing neoadjuvant chemotherapy. Methods: The cross sectional study was conducted at Aznostics the diagnostic Centre, Lahore. Forty cases of local wide excision and mastectomies were taken and were xed in 10% formalin. Hematoxylin and eosin staining was done on the representative sections to observe the pathological changes that occurred after a minimum of 4 cyc l e s of neoadjuvant chemotherapy. Miller Payne system of classication was used for the pathological assessment of breast tumor in patients going thr ough ne o adjuv ant chemo the r apy . Results: Forty cases were included in the study. Mostly having histological grades 3 and 2. In all, complete pathological response (pCR) was observed in 7(17.5%) patients according to Miller Payne Classication (grade 5). Incomplete response is observed in 33 cases, out of which 5 ( 1 2 . 5 % ) c a s e s sho w ed Mill e r Pa yne Classication grade 4, 8(20%) cases showed grade 3, 17(42.5.5%) belongs to grade 2 and 3 ( 7 . 5 % ) c a s e s s h o w e d M i l l e r P a y n e chemotherapy effect grade 1. Only one case with pCR reported ductal carcinoma in situ. 7 patients showed lymphovascular invasion and in remaining 31 cases no lymphovascular invasion is identied. Conclusions: Neoadjuvant therapy is currently a suitable treatment modality for the breast carcinoma patients. However, the pathological evaluation is still considered as a gold standard for the exact diagnosis of cancer. The role of a pathologist cannot be ignored in this regard. Pathologic assessment as a prognostic marker is still a gold standard for patient's adjuvant for research and clinical trials. Keywords: Breast carcinoma, complete pathological r e spons e (pCR), Mill e r c l a s s ic a tion, Neoadjuvant therapy, Prognostic marker.