The effects of chemotherapy on breast cancer tissue in locally advanced breast cancer

Abstract

It is well known that chemotherapy induces cytomorphological changes in neoplastic and non-neoplastic tissue. Thirty-one stage III breast-carcinoma patients, treated with both pre-operative chemotherapy and mastectomy, were evaluated to define the effects of systemic chemotherapeutic agents in tumours, non-neoplastic breast tissue, and lymph nodes. Histological changes were compared with those observed in patients who had been treated by surgery alone. Cytoplasmic vacuolization was the most striking change in the tumour cells (59%). Chemotherapy was especially effective in the terminal duct lobular unit in non-neoplastic breast tissue. Lobular atrophy was observed in 20 (65%) cases, and lobular cellular atypia was seen in 16 (52%). The rate of ductal cellular atypia (42%) was not different from the control group. The most important changes seen in the non-neoplastic stromal component were fibrosis and hyalinization. These were found in 31 out of 727 evaluated lymph nodes. In serial sections, metastatic deposits were seen in or around these fibrotic or hyalinized areas. Chemotherapy is widely used in the treatment of early and locally advanced breast carcinomas. Familiarity with chemotherapy induced changes in breast tissue and lymph nodes have considerable importance in the accurate interpretation of these specimens.

Breast cancer response to neoadjuvant chemotherapy: predictive markers and relation with outcome

“…Regressive cytonuclear alterations were scored if marked anisocytosis, vacuolisation and increase of nuclear size was seen in residual tumour cells. The few publications addressing the subject of breast cancer morphology after chemotherapy essentially describe the same pattern of changes that we found (Kennedy et al, 1990;Aktepe et al, 1996;Miller et al, 1997;Gajdos et al, 2002).…”

“…In addition, there are an increasing number of studies investigating factors that can predict response to chemotherapy. Histopathological changes of breast tumours as a result of chemotherapy exposure have been described in a limited number of papers (Kennedy et al, 1990;Aktepe et al, 1996;Miller et al, 1997;Gajdos et al, 2002).…”

Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy

“…However, the current study indicates that the effect of chemotherapy on lymph node metastases is limited; the rate of ypN0 cases was only 14%, compared with 10% for pT3-4 tumors treated with surgery alone. 30 Although we found areas of fibrosis and hyalinosis, indicating complete destruction of nodal metastases in lymph nodes, which also have been described in breast carcinoma treated with chemotherapy, 32 this was not a common finding. Becker et al 33 reported that chemotherapy reduces the rate of tumor cell microinvolvement in neoadjuvantly treated gastric carcinoma.…”

“…These cells have been described in connection with regression observed in osteosarcoma. 8,9 Carcinomas of the breast 32 and esophagus, 12 being derived from the mononuclear phagocytic system, are believed to be particularly active in the clearance of apoptotic cells. 34 Their presence in the patients treated with chemotherapy could be an indication of areas in which tumor cells underwent apoptosis induced by the chemotherapeutic agent.…”

Added Value of Baseline 18F-FDG Uptake in Serial 18F-FDG PET for Evaluation of Response of Solid Extracerebral Tumors to Systemic Cytotoxic Neoadjuvant Treatment: A Meta-Analysis

“…In all studies, surgical resection of the tumor was scheduled within weeks after completion of the neoadjuvant treatment. The pathologic definition of response differed per malignancy and is displayed in Table 2 (24)(25)(26)(27). Because studies were performed over a period of almost a decade (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008), no standardized PET protocol was used, and variable scanners, scan modes, 18 F-FDG doses, time intervals (between injection of 18 F-FDG and the PET scan, between the completion of the induction therapy and the posttreatment PET, and between the posttreatment PET and surgery), and image-reconstruction methods were used.…”