Pathological assessment of breast carcinoma specimens undergoing neoadjuvant chemotherapy

Amber Hassan; Imrana Tanvir; Rizwan Ullah; Sabiha Riaz

doi:10.52229/ajahs.v3i3.338

Amber Hassan Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan
Imrana Tanvir Pathology Department, King Abdul Aziz University, Rabigh, Saudi Arabia
Rizwan Ullah Pathology Department, Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan
Sabiha Riaz Pathology Department, Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan

DOI: https://doi.org/10.52229/ajahs.v3i3.338

Keywords: Breast carcinoma, complete pathological r e spons e (pCR), Mill e r c l a s s ic a tion, Neoadjuvant therapy, Prognostic marker.

Abstract

Breast Carcinoma (BC) is the frequent type of diagnosed cancers in females.

Objective: To determine the pathological assessment of breast carcinoma specimens undergoing neoadjuvant chemotherapy.

Methods: The cross sectional study was conducted at Aznostics the diagnostic Centre, Lahore. Forty cases of local wide excision and mastectomies were taken and were fixed in 10% formalin. Hematoxylin and eosin staining was done on the representative sections to observe the pathological changes that occurred after a minimum of 4 cyc l e s of neoadjuvant chemotherapy. Miller Payne system of classification was used for the pathological assessment of breast tumor in patients going through neo-adjuvant chemo therapy.

Results: Forty cases were included in the study. Mostly having histological grades 3 and 2. In all, complete pathological response (pCR) was observed in 7(17.5%) patients according to Miller Payne Classification (grade 5). Incomplete response is observed in 33 cases, out of which 5 (1 2 . 5 % ) cases showed Mille Pa ne Classification grade 4, 8(20%) cases showed grade 3, 17 (42.5.5%) belongs to grade 2 and 3 ( 7 . 5 % ) cases showed Miller Payn e chemotherapy effect grade 1. Only one case with pCR reported ductal carcinoma in situ. 7 patients showed lymphovascular invasion and in remaining 31 cases no lymphovascular invasion is identified.

Conclusions: Neoadjuvant therapy is currently a suitable treatment modality for the breast carcinoma patients. However, the pathological evaluation is still considered as a gold standard for the exact diagnosis of cancer. The role of a pathologist cannot be ignored in this regard. Pathologic assessment as a prognostic marker is still a gold standard for patient's adjuvant for research and clinical trials.