Evaluation of the Surgical Specimen After Neoadjuvant Systemic Therapy

ConclusionPostneoadjuvant systemic therapy histopathological changes are complex, and careful systematic review of the specimen is required for accurate diagnosis and follow-up treatment. For pathological complete response to be used as an indicator of response to novel therapies, it is essential to have a standardized way in which residual disease is measured and reported. We designed the recommendations specifically for the clinical trial setting; however, they can be optionally incorporated into routine practice because, in our opinion, standardization is most effective when uniformly applied. Hopefully, such standardization will improve our knowledge and ability to compare outcomes, promote the submission of specimens for translational research, and facilitate the more timely introduction of new agents.The recommendation of this committee is that pathologic reports of residual disease after neoadjuvant chemotherapy and/or targeted therapy in clinical trials should include the following information:Pathological Complete Response or Residual Disease. This should separately describe whether there was residual invasive cancer in the breast, in situ cancer in the breast, and the pathologic status of the regional lymph nodes.Residual Cancer Burden as the preferred method for more detailed quantification of residual disease. The report should provide the final residual tumor dimensions, cellularity of cancer in the final tumor bed area and the proportion of in sit...
Source: Oncopathology - Category: Cancer & Oncology Tags: breast Breast Biopsy Procedure breast cancer Source Type: blogs