Assessment of pathological response to neoadjuvant chemotherapy in patients with breast carcinoma using Sataloff system

Q4 Medicine
S. Agarwal, P. Pandey, M. Ralli, V. Chaturvedi, K. Mittal, Shailendra Singh
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引用次数: 0

Abstract

Background: Neoadjuvant chemotherapy is frequently administered to patients with breast carcinoma. Response to chemotherapeutic regime can be assessed clinically as well as by pathological examination of the breast tissue. It is essential to accurately categorize the patients with residual disease according to the standard guidelines for pathological evaluation of breast specimens after neoadjuvant chemotherapy. The present study was undertaken to assess the histomorphological changes in mastectomy specimens and axillary lymphatic nodes of patients receiving neoadjuvant chemotherapy, grade the pathological response using Sataloff system and to compare the clinical and pathological response after neoadjuvant chemotherapy. Methods: Present prospective study included a total of 31 patients with locally advanced breast carcinoma, diagnosed with infiltrating ductal carcinoma, not otherwise specified on biopsy specimen and subsequently treated with 2 to 6 cycles of neoadjuvant chemotherapy. Pathological response to neoadjuvant chemotherapy was assessed in breast and axillary lymphatic nodes according to Sataloff criteria. Results: Clinical response observed was complete (cCR) in four cases (12.9%), partial response (cPR) in 24 cases (77.4%), and no response (cNR) in three cases (9.7%). Based on tumor response, breast and lymph nodes were graded as pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR) in five (16.1%), 18 (58.1%) and eight (25.8%) cases respectively using Sataloff criteria. Ductal carcinoma in situ and lymphovascular invasion were seen in 11 (35.4%) and 16 cases (51.6%), respectively. Conclusion: The pathological assessment of tumor response remains the gold standard, as neither the clinical nor the radiological responses are sensitive predictors of tumor response after treatment. However pathological examination is quite challenging and demands sufficient experience along with detailed clinical and radiological data of pre- and postoperative neoadjuvant chemotherapy for precise response evaluation.
Sataloff系统评价乳腺癌患者新辅助化疗的病理反应
背景:乳腺癌患者常接受新辅助化疗。对化疗方案的反应可以通过临床以及乳腺组织的病理检查来评估。根据新辅助化疗后乳腺标本病理评价的标准指南,准确地对残留病变患者进行分类是至关重要的。本研究评估新辅助化疗患者乳腺切除术标本及腋窝淋巴结的组织形态学变化,采用Sataloff系统对病理反应进行分级,并比较新辅助化疗后的临床和病理反应。方法:本前瞻性研究共纳入31例局部晚期乳腺癌患者,诊断为浸润性导管癌,活检标本无其他说明,随后接受2至6个周期的新辅助化疗。根据Sataloff标准评估乳腺和腋窝淋巴结对新辅助化疗的病理反应。结果:临床完全缓解(cCR) 4例(12.9%),部分缓解(cPR) 24例(77.4%),无缓解(cNR) 3例(9.7%)。根据肿瘤反应,采用Sataloff标准将5例(16.1%)、18例(58.1%)和8例(25.8%)乳腺和淋巴结分别分级为病理完全缓解(pCR)、病理部分缓解(pPR)和病理无缓解(pNR)。导管原位癌11例(35.4%),淋巴血管浸润16例(51.6%)。结论:肿瘤反应的病理评估仍然是金标准,因为临床和放射反应都不是治疗后肿瘤反应的敏感预测指标。然而,病理检查具有很大的挑战性,需要足够的经验以及详细的术前和术后新辅助化疗的临床和放射学资料才能准确评估疗效。
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来源期刊
Archive of Oncology
Archive of Oncology Medicine-Oncology
CiteScore
0.60
自引率
0.00%
发文量
5
审稿时长
12 weeks
期刊介绍: Archive of Oncology is an international oncology journal that publishes original research, editorials, review articles, case (clinical) reports, and news from oncology (medical, surgical, radiation), experimental oncology, cancer epidemiology, and prevention. Letters are also welcomed. Archive of Oncology is covered by Biomedicina Vojvodina, Biomedicina Serbica, Biomedicina Oncologica, EMBASE/Excerpta Medica, ExtraMED and SCOPUS.
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