RT Journal Article
SR Electronic
T1 Breast specimen handling and reporting in the post-neoadjuvant setting: challenges and advances
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 120
OP 132
DO 10.1136/jclinpath-2018-205598
VO 72
IS 2
A1 Miralem Mrkonjic
A1 Hal K Berman
A1 Susan J Done
A1 Bruce Youngson
A1 Anna Marie Mulligan
YR 2019
UL http://jcp.bmj.com/content/72/2/120.abstract
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.