Evaluation of Pathological Response in Post-Neoadjuvant Chemotherapy Breast Carcinoma Specimens using Residual Cancer Burden System

Journal of Clinical and Diagnostic Research

卷:15

Lakshmi Manasa Perubhotla¹  Sudha S Murthy²  Suseela Kodandapani³ 

[1] Consultant Pathologist, Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Secunderabad, Telangana, India.;

[2] Former Head, Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.;

[3] Head, Department of Pathology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.;

关键词: pathological complete response;    tumour cell;    therapy related changes;   

DOI  :  10.7860/JCDR/2021/48102.14917

来源: DOAJ

【 摘 要 】

Introduction: Many systems have been proposed to classifythe degree of tumour response to therapy in post-neoadjuvantChemotherapy (NACT) breast cancers. The Residual CancerBurden (RCB) developed by MD Anderson cancer hospital isan online tool for the quantification of residual disease that iseasy to practice, reproducible, and the RCB score has beenclinically validated as independent prognostic factor for longterm survival.Aim: To evaluate the methodology for grossing andmicroscopic examination for assessing pathologic responsein postNACT breast cancer specimens using RCB systemdeveloped by MD Anderson cancer institute and its feasibilityfor routine practice.Materials and Methods: The present cross-sectional studywas conducted in Basavatarakam Indo American CancerHospital and Research Institute Hyderabad over a durationof three months from May 2018 to July 2018. Histologicallyproven breast carcinoma patients who were treated with bothNACT and surgery were included in the study. Before surgery,these patients were treated with either anthracycline-basedchemotherapy regimen with or without additional taxanes ortargeted therapy with transtuzumab. RCB score and class werecalculated to assess pathologic response to NACT. Analysiswas performed individually by two senior pathologists, whohas expertise in breast pathology and a junior pathologist.Consensus opinion was noted in case of discrepancies.Results: The study included 50 carcinoma breast specimens.All the cases werefemales. 49 cases were diagnosed asinvasive carcinoma, No Special Type (NST) and one was lobularcarcinoma. pCR (Pathological complete response) was seen in9 (18%) and residual disease was seen in 41 (82%) patients.Conclusion: The present study highlights feasibility ofapplication of RCB system in assessing pathological responsefollowing NACT in breast cancer. Incorporating RCB score andclass in the reporting helps the surgical pathologist to overcomesampling errors caused by heterogeneously variable cellularitycommonly encountered in these type of specimens.

【 授权许可】

Unknown