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Morphologic Changes Induced by the Oncologic Treatment for Breast Carcinoma (Chemotherapy, Radiotherapy, Hormonal Therapy)

  • Aziza Nassar
Chapter

Abstract

Neoadjuvant treatment has become a standard of care for selected high-risk breast cancers including tumors ≥2 cm and for locally advanced unresectable disease. Neoadjuvant chemotherapy (NAC) offers many advantages, including reducing the tumor size and potentially making patients candidates for breast conservation therapy (BCT), as well as allowing early assessment of response to chemotherapy treatment [1–3]. The main advantage of neoadjuvant chemotherapy is in shrinking tumors, which makes inoperable tumors amenable to surgery and allows better outcomes for patients [4–7]. NAC also provides information on tumor response to specific chemotherapeutic agents, and it provides data for investigating molecular determinants of chemotherapeutic response [8–10]. Pathologic complete response (pCR) provides an early surrogate marker of long-term survival, marking a benefit from chemotherapeutic treatment [4–7]. pCR is noted in only 10–20% of patients who were subjected to NAC [11]. There are several predictors of response to preoperative chemotherapy, including both clinical and pathologic variables such as estrogen-receptor negative (ER-) status, high-grade tumor, high proliferative activity, HER2 amplification, negative lymph node status, and smaller tumor size, among others [1, 4, 7, 12–16]. Histologic subtype also determines the response of the tumor to NAC; for example, lobular cancers do not respond well to NAC as compared to ductal cancers [2, 5, 8, 16, 17].

Keywords

Morphologic changes Neoadjuvant therapy Histopathologic changes Radiologic changes 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pathology and Laboratory MedicineMayo ClinicJacksonvilleUSA

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