Procedure for intraoperative material examination in breast cancer after neoadjuvant therapy to estimate residual cancer burden using the RCB system

Abstract

Currently, neoadjuvant therapy has been shown to be effective in treating HER2-positive breast cancer; the development and assessment of novel medications and therapy regimens are being continued. A tumor response to the treatment is the most important factor in planning adjuvant therapy. The use of different systems to evaluate a therapeutic effect gives rise to significant differences in estimating the rate of complete morphological regression according to the results of performed therapy. The paper describes a procedure to estimate cancer burden using the RCB system. This procedure is highly reproducible and recommended by the 2015 European Society for Medical Oncology Clinical Practice Guidelines for the management of primary breast cancer.

Tailoring neoadjuvant chemotherapy for patients with breast cancer who have achieved pathologic complete response

“…NACT did not improve survival in patients with similar baseline characteristics and chemotherapy regimens when compared with adjuvant chemotherapy ( 3 ). However, residual cancer burden has been demonstrated as a useful predictor of survival after NACT ( 4 , 5 ), especially in patients with triple-negative or HER2-positive breast cancer; thus, patients who have not achieved pCR could benefit significantly from intensive postoperative adjuvant chemotherapy ( 6 , 7 ). The prognosis of patients with pCR is good, and additional adjuvant chemotherapy may not confer survival benefits of clinical or statistical significance.…”