PT - JOURNAL ARTICLE AU - Miralem Mrkonjic AU - Hal K Berman AU - Susan J Done AU - Bruce Youngson AU - Anna Marie Mulligan TI - Breast specimen handling and reporting in the post-neoadjuvant setting: challenges and advances AID - 10.1136/jclinpath-2018-205598 DP - 2019 Feb 01 TA - Journal of Clinical Pathology PG - 120--132 VI - 72 IP - 2 4099 - http://jcp.bmj.com/content/72/2/120.short 4100 - http://jcp.bmj.com/content/72/2/120.full SO - J Clin Pathol2019 Feb 01; 72 AB - Neoadjuvant systemic therapy is becoming more commonly used in patients with earlier stages of breast cancer. To assess tumour response to neoadjuvant chemotherapy, pathological evaluation is the gold standard. Depending on the treatment response, the pathological examination of these specimens can be quite challenging. However, a uniform approach to evaluate post-neoadjuvant-treated breast specimens has been lacking. Furthermore, there is no single universally accepted or endorsed classification system for assessing treatment response in this setting. Recent initiatives have attempted to create a standardised protocol for evaluation of post-neoadjuvant breast specimens. This review outlines the necessary information that should be collected prior to macroscopic examination of these specimens, the recommended and most pragmatic approach to tissue sampling for microscopic examination, describes the macroscopic and microscopic features of post-therapy breast specimens, summarises two commonly used systems for classifying treatment response and outlines the critical variables that should be included in the final pathology report.