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Pathology of breast carcinoma after neoadjuvant therapy

Posted May 20 2009 12:00am

If you do not receive Archives of Pathology and Laboratory Medicine or haven't caught up with the April 2009 issue yet, I strongly encourage you to read the article by Drs. Sahoo and Lester, "Pathology of Breast Carcinoma after Neoadjuvant Chemotherapy."  This is an emerging topic in breast cancer and, after listening to a presentation at the 2008 ASCO Annual Meeting on neoadjuvant therapy (NAT) for breast cancer, I feared encountering such a patient's specimen and not knowing how to approach this situation.

This article does not provide much background into the subject but does describe the gross and microscopic pathologic changes seen in carcinomas and lymph nodes due to NAT, outlines the various extant systems for evaluating pathologic response to treatment, and has numerous practical points for evaluating these specimens.  There is also a summary for reporting these specimens that can be adapted to a "checklist" format.

Highly recommended reading.

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