Pathologic Changes Related to CMF Primary Chemotherapy in Breast Cancer

Abstract

The pathologic changes associated to response to primary chemotherapy in a series of 303 operable breast cancers are evaluated and correlated to patients' follow-up (interval free of disease and survival). In our series, the incidence of microscopic changes related to chemotherapy is 43.9%. Tumor replacement by loose fibrosis is the most common pathologic event. In most cases, the intensity of fibrotic change is proportional to the degree of clinical-mammographic reduction of the tumor mass. However, some discrepancies exist in the sense of absence of microscopic changes in cases of well-documented mammographic reduction as well as in cases without clinical reduction but with large areas of chemotherapy-related fibrosis. The presence of pathologic response is significantly associated with better survival rate.

Histopathologic changes following neoadjuvant chemotherapy in various malignancies

“…[510–1214] The most common inflammatory host response observed in the present study was lymphocytic; others included mixed inflammation, plasmacytic, prominent histiocytic, and giant cell types. Giant cell reaction was significantly correlated to all types of tumor responses ( P < 0.05).…”

Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

“…MTX is used (alone or in combination) to treat both early-stage (as well after surgery and other treatments) and advanced-stage breast cancer. Some selected application of MTX in breast cancer therapy are presented below [196,[213][214][215][216][217][218][219][220][221]244,[265][266][267], Table 2. Martin et al described numerous combination regimens applied in metastatic breast cancer, such as CTX, MTX, 5-FU (CMF), 5-FU, Adriamycin, CTX (FAC) and MTX in combination with tegafur and uracil followed by LV rescue (MUL) [213,214].…”

“…The same research group presented the benefit of application of combination regimen CMF followed by tamoxifen or tamoxifen alone, as adjuvant chemotherapy in women with lymph node-negative breast cancer [266]. Based on experimental data, the authors showed that the classical CMF regimen is safe and plays a key role in the response to therapy in early breast cancer [215,216]. Cocconi et al compared CMF regimen with the modified CMF method they proposed.…”

Histopathological markers of treatment response and recurrence risk in ovarian cancers and borderline tumors

“…Two additional thresholds have been identified to provide prognostic information in various tumors: response defined by less than 10% of residual viable tumor, and non-response defined by more than 50% residual tumor [7, 9, 14]. Further histopathologic changes following cytotoxic therapy include lymphocytic and histiocytic infiltrates with macrophage activation and subsequent presence of foamy macrophages and giant cells of foreign-body type, and cytopathic changes such as enlargement of tumor cells and the presence of multinucleated giant tumor cells [7, 9, 11, 12, 15, 16]. Nevertheless, there is little information available regarding histopathologic response criteria in ovarian cancer.…”