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International Journal of Breast CancerVolume 2015 2015, Article ID 536145, 8 pages

Research Article

Department of Pathology, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala 689101, India

Department of Pathology, Government Medical College, Thrissur, Kerala 680596, India

Department of Oncology, Government Medical College, Alappuzha, Kerala 688005, India

Department of Pathology, Government Medical College, Alappuzha, Kerala 688005, India

Received 30 July 2015; Revised 29 October 2015; Accepted 1 November 2015

Academic Editor: Claudio Luparello

Copyright © 2015 Dhanya Vasudevan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. Paclitaxel based neoadjuvant chemotherapy regimen NAT in the setting of locally advanced breast cancer LABC can render inoperable tumor T4, N2-N3 resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response. Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response pCR, pathological partial response pPR, and pathological no response pNR. Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors 2–5 cms and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed. Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.





Autor: Dhanya Vasudevan, P. S. Jayalakshmy, Suresh Kumar, and Siji Mathew

Fuente: https://www.hindawi.com/



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