Characterization and clinical impact of residual disease after neoadjuvant chemotherapy

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

One of the most important lessons learned from trials of neoadjuvant chemotherapy (NACT) is that achievement of pathological complete response (pCR) is a powerful prognostic predictor of long-term outcome, with significantly better disease-free and overall survival for patients achieving pCR, as compared with patients having residual tumour after NACT. The pathologists' role in the neoadjuvant setting is: (i) to ensure an accurate assessment of pCR, and (ii) to evaluate burden and biological characteristics of residual tumour if pCR has not been achieved. A conversion of receptor status from the core biopsy to the post-NACT surgical specimen may cause uncertainty in the choice of the post-surgical systemic treatment for the patients. It is therefore imperative to ensure accuracy in the assessment of ER, PgR and HER2, and to double check any apparent conversion by re-staining the previous core biopsy and the residual tumour in the same run, thus minimizing the technical artifacts, and to use both immunohistochemical and in situ hybridization assays to evaluate HER2 status. It is essential that protocols for evaluation of tumour response and for assessment of prognostic/predictive parameters of residual disease after NACT be eventually harmonized.

Original languageEnglish
JournalBreast
Volume22
Issue numberS2
DOIs
Publication statusPublished - Aug 1 2013

Fingerprint

Residual Neoplasm
Drug Therapy
Biopsy
Artifacts
Disease-Free Survival
Uncertainty
In Situ Hybridization
Staining and Labeling
Neoplasms
Therapeutics

Keywords

  • Breast cancer
  • Immunohistochemistry
  • Neoadjuvant chemotherapy
  • Pathology of residual breast cancer
  • Tumour markers

ASJC Scopus subject areas

  • Surgery

Cite this

Characterization and clinical impact of residual disease after neoadjuvant chemotherapy. / Viale, Giuseppe.

In: Breast, Vol. 22, No. S2, 01.08.2013.

Research output: Contribution to journalArticle

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