Purpose: The objective of the present study was to evaluate pathological response based on morphologic details to neoadjuvant chemotherapy (NACT) in treatment of breast cancer which can help to predict prognosis.
Methods: It was a descriptive study of 35 cases, where microscopic slides of trucut biopsies and modified radical mastectomy (MRM) specimens before and after NACT were examined by pathologist for morphological details.
Results: The mean tumour size before and after NACT was 4.65 and 3.04 cm respectively (p<0.001). The median cellularity in pre and post NACT specimens were 60% and 50% respectively (p<0.001). Post NACT, out of35, 5.71% were stage IA, 17.14% were stage IIA, 25.73% were stage IIB, 20% were stage IIIA, 2.85% were stageIIIB and 8.57% were stage IIIC. Total 7 cases were stage 0 as they had complete pathologic response. Post NACT, many histomorphological changes (nuclear, cytoplasmic, stromal) in affected as well as adjacent normal breast were statistically significant (p<0.05). Pathologic response was complete in 20%, partial in 54.28% and no response in24.72% cases.
Conclusions: NACT causes morphological alterations in cancerous as well as surrounding healthy tissue. Pathologic evaluation of the tumour response is gold standard. Post NACT staging of tumour is better predictor of survival. This ensures that the role of the pathologist is extremely important in correct diagnosis as well as grading of the tumour. It helps in an effective and planned regimen of the therapy leading to better prognosis.
Impact Factor
2022: 6.012
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