Abstract:
BACKGROUND:Neoadjuvant endocrine therapy (NAET) is used in the management of estrogen receptor positive (ER+) breast cancer. The optimal method for histological assessment of response and the effect of NAET on the tumour morphology, grade and molecular profile remain unclear. MATERIAL AND METHODS:A single large institution cohort of 132 patients who received NAET over a 13-year period was identified. Comprehensive clinical, histopathological and follow up data were collected. A detailed histological review of a subset with residual post-treatment carcinoma was undertaken. RESULTS:Two carcinomas (both of lobular type) achieved complete pathological response. Central scarring was seen in 49.3% of tumours post-treatment. Significant changes in tumour type (41.6%), grade (downgrading in a third of tumours), PR expression (22.3%) with a switch to PR negative status in 17.6% of cases were observed. The latter was associated with absence of tumour infiltrating lymphocytes (p=0.005). 10% of cases showed a change in HER2 expression (p=0.002). Median patient survival was 60 months and downgrading of tumours was associated with better overall survival (p=0.05). CONCLUSIONS:We propose a histological method for assessment of residual carcinoma following NAET and recommend repeat ER/PR/HER2 testing to inform management and prognosis.
journal_name
Histopathologyjournal_title
Histopathologyauthors
Badr NM,Spooner D,Steven J,Stevens A,Shaaban AMdoi
10.1111/his.14331subject
Has Abstractpub_date
2021-01-10 00:00:00eissn
0309-0167issn
1365-2559pub_type
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