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Category: Volume 07 Issue 02 February 2019
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Title: Evaluation of morphological predictors for response to NACT in breast cancer

Authors: Gundimeda V R N Krishna Kanth MD, PDCC (Oncopathology), Nambiar Ajit MD, DNB, FRCPath

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.103

Abstract

Background: NACT is being increasingly employed to deal with breast malignancies. It is important to know the predictive value of various morphological parameters for the pathological complete response. It is also interesting to note the various changes that happen to tumor bed due to chemotherapy.

Aims and Objectives: 1)To evaluate the importance of various morphological parameters in predicting response to NACT 2)To observe histological changes in the tumor bed after NACT.

Materials and Methods: A total of 108 cases where NACT was given were selected over a 3 year old period and clinical and histological parameters were assessed prior to and after NACT.

Results: The statistical significance for the association of various parameters is calculated and it was found that age has no influence on response to NACT where as morphological subtype, size of the tumor, grade of the tumor before NACT, Lymph node status after NACT, DCIS, tumor lymphocytic response  were all found to be associated statistically with complete pathological response. Fibrosis and necrosis were the common changes that happen to the tumor bed due to chemotherapy

Conclusions: Even in the current era of molecular pathology, basic morphological parameters still play a pivotal role in selecting the patients for NACT.

Keywords: NACT (Neo adjuvant chemotherapy), PCR (Pathological complete response), NOS (Not otherwise specified),RCB(Residual cancer burden).

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Corresponding Author

Nambiar Ajit MD, DNB, FRCPath

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