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Macroscopic handling and reporting of breast cancer specimens pre- and post-neoadjuvant chemotherapy treatment: review of pathological issues and suggested approaches

Pinder, Sarah E; Rakha, Emad A; Purdie, Colin A; Bartlett, John M S; Francis, Adele; Stein, Robert C; Thompson, Alastair M; Shaaban, Abeer M; the Translational Subgroup of the NCRI Breast Clinical Studies Group

Authors

Sarah E Pinder

EMAD RAKHA Emad.Rakha@nottingham.ac.uk
Professor of Breast Cancer Pathology

Colin A Purdie

John M S Bartlett

Adele Francis

Robert C Stein

Alastair M Thompson

Abeer M Shaaban

the Translational Subgroup of the NCRI Breast Clinical Studies Group



Abstract

Neoadjuvant chemotherapy (NACT) is used increasingly in the treatment of invasive breast cancer and presents challenges for the pathologist in the handling and interpretation of tissues. Potential issues include pathological identification and localization of the residual tumour site; how best to assess pathological response (given the diversity of scoring systems described); the timing and assessment of axillary node biopsy; and the value of retesting any residual tumour for dissonance between core biopsy and post?treatment residual cancer cells for biomarker expression such as oestrogen and progesterone receptors and human epidermal growth factor receptor 2 (HER2). The role of the pathologist is critical in modern NACT approaches to breast cancer and is likely to remain challenging as novel agents and newer biomarkers become available. In this manuscript we review these issues and describe some practical approaches to handling and reporting these samples in the routine histopathology laboratory.

Citation

Pinder, S. E., Rakha, E. A., Purdie, C. A., Bartlett, J. M. S., Francis, A., Stein, R. C., …the Translational Subgroup of the NCRI Breast Clinical Studies Group. (2015). Macroscopic handling and reporting of breast cancer specimens pre- and post-neoadjuvant chemotherapy treatment: review of pathological issues and suggested approaches. Histopathology, 67(3), 279-293. https://doi.org/10.1111/his.12649

Journal Article Type Article
Acceptance Date Jan 14, 2015
Online Publication Date Mar 8, 2015
Publication Date 2015-09
Deposit Date Nov 20, 2018
Journal Histopathology
Print ISSN 0309-0167
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 67
Issue 3
Pages 279-293
DOI https://doi.org/10.1111/his.12649
Public URL https://nottingham-repository.worktribe.com/output/1288755
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1111/his.12649