DOI: 10.7860/JCDR/2014/7594.4283
Original Article
Pathology Section
Study of Tumour Cellularity in Locally Advanced Breast Carcinoma on Neo-Adjuvant Chemotherapy
Swarup Kumar1, Bhawana Ashok Badhe2, KM Krishnan3, Haritha Sagili4
ABSTRACT Background: Breast cancer is the most common invasive malign ancy which occurs in women worldwide. The advent of neoadjuvant chemotherapy has radically changed the management of locally advanced breast cancer and a complete response is reported to significantly improve disease free survival. Traditionally, clinical response is assessed on basis of tumour size. In this study, an attempt was made to check whether tumour cellularity could be a better prognostic factor and also to check as to what impact the correlation of tumour size with cellularity had on the response assessment in locally advanced breast cancer patients. Materials and Methods: Thirty seven patients with locally advanced breast cancer, who were treated by neoadjuvant chemotherapy during the period of December 2008 to May 2009, were selected for the study and from their case records, tumour size, clinical response and demographic details were gathered. Tumour cellularity was assessed prior to chemotherapy in core needle biopsy sections and it was matched with that seen in
subsequent mastectomy specimens. Tumour size and cellularity were then correlated with the different treatment response groups and they were statistically analyzed by using the SPSS, version 13.0 software. Results: After neoadjuvant chemotherapy, the tumour size and cellularity were found to be significantly reduced in breast carcinomas (p50% in tumour size;
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a no response (NR) was defined as a reduction in tumour size of 80% cellularity comprised of infiltrating duct cell carcinoma infiltrating the underlying fibrotic stroma. X200, Hematoxylin and Eosin stain; [Table/Fig-7b]: Section from core needle biopsy show > 75% cellularity comprised of infiltrating duct cell carcinoma infiltrating the underlying fibrotic stroma. X100, Hematoxylin and Eosin stain
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(b)
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[Table/Fig-9a]: Section from mastectomy specimen, post neoadjuvant chemo therapy showing 80% cellularity and > 75 % cellularity under high power magnification (x 200). In [Table/Fig-8a], section from the mastectomy specimen post neoadjuvant chemotherapy shows < 10% cellularity depicting a marked reduction in tumor cellularity while [Table/Fig-8a] shows a higher magnification (x200) of the same section as in [Table/ Fig-8b]. [Table/Fig-9a] depicts a section from the mastectomy specimen post neoadjuvant chemotherapy with
Original Article
Pathology Section
Study of Tumour Cellularity in Locally Advanced Breast Carcinoma on Neo-Adjuvant Chemotherapy
Swarup Kumar1, Bhawana Ashok Badhe2, KM Krishnan3, Haritha Sagili4
ABSTRACT Background: Breast cancer is the most common invasive malign ancy which occurs in women worldwide. The advent of neoadjuvant chemotherapy has radically changed the management of locally advanced breast cancer and a complete response is reported to significantly improve disease free survival. Traditionally, clinical response is assessed on basis of tumour size. In this study, an attempt was made to check whether tumour cellularity could be a better prognostic factor and also to check as to what impact the correlation of tumour size with cellularity had on the response assessment in locally advanced breast cancer patients. Materials and Methods: Thirty seven patients with locally advanced breast cancer, who were treated by neoadjuvant chemotherapy during the period of December 2008 to May 2009, were selected for the study and from their case records, tumour size, clinical response and demographic details were gathered. Tumour cellularity was assessed prior to chemotherapy in core needle biopsy sections and it was matched with that seen in
subsequent mastectomy specimens. Tumour size and cellularity were then correlated with the different treatment response groups and they were statistically analyzed by using the SPSS, version 13.0 software. Results: After neoadjuvant chemotherapy, the tumour size and cellularity were found to be significantly reduced in breast carcinomas (p50% in tumour size;
•
a no response (NR) was defined as a reduction in tumour size of 80% cellularity comprised of infiltrating duct cell carcinoma infiltrating the underlying fibrotic stroma. X200, Hematoxylin and Eosin stain; [Table/Fig-7b]: Section from core needle biopsy show > 75% cellularity comprised of infiltrating duct cell carcinoma infiltrating the underlying fibrotic stroma. X100, Hematoxylin and Eosin stain
(a)
(b)
(a)
(b)
[Table/Fig-9a]: Section from mastectomy specimen, post neoadjuvant chemo therapy showing 80% cellularity and > 75 % cellularity under high power magnification (x 200). In [Table/Fig-8a], section from the mastectomy specimen post neoadjuvant chemotherapy shows < 10% cellularity depicting a marked reduction in tumor cellularity while [Table/Fig-8a] shows a higher magnification (x200) of the same section as in [Table/ Fig-8b]. [Table/Fig-9a] depicts a section from the mastectomy specimen post neoadjuvant chemotherapy with
