Processing and Reporting of Breast Specimens in the Neoadjuvant Setting

Surg Pathol Clin. 2018 Mar;11(1):213-230. doi: 10.1016/j.path.2017.09.010. Epub 2017 Dec 11.

Abstract

Standardization of quantification of residual disease in the breast and lymph nodes with routine pathologic macroscopic and microscopic evaluation leads to accurate and reproducible measures of response to neoadjuvant treatment. Multidisciplinary collaboration and correlation of clinical, imaging, gross and microscopic findings is essential. The processing approach to post-neoadjuvant breast cancer surgical specimens and the elements needed in the pathology report are the same regardless of breast cancer subtype or type of neoadjuvant treatment. The residual cancer burden incorporates response in the breast and in the lymph nodes into a score that can be combined with other emerging prognostic factors.

Keywords: Breast cancer; Cellularity; Neoadjuvant; Pathology; Residual disease; Response to treatment; Sampling; pCR.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology*
  • Humans
  • Interdisciplinary Communication
  • Lymph Nodes / pathology*
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Neoadjuvant Therapy
  • Neoplasm, Residual / pathology*
  • Practice Guidelines as Topic
  • Specimen Handling
  • Tumor Burden / immunology