Approach to Neoadjuvant-Treated Breast Cancer Cases

Neoadjuvant treated breast cancer specimens are among the most technically challenging breast specimens to evaluate. The response to neoadjuvant chemotherapy provides crucial prognostic information and guides additional treatment planning. Therefore, accurate pathologic evaluation of these specimens is critical for patient management. This lecture will review how to approach these specimens, including how to perform a careful and systematic gross examination, how to evaluate patterns of residual disease, and how to navigate the different systems for reporting residual disease (RCB and AJCC).

Lecture Presenter
Allison Cleary, MD, PhD
Allison Cleary, MD, PhD
Assistant Professor, University of Utah School of Medicine
Pathologist, ARUP Laboratories

Dr. Allison Cleary is a pathologist at ARUP Laboratories, and an assistant professor (clinical) for the University of Utah School of Medicine. Dr. Cleary received her MD and PhD from the Pennsylvania State University College of Medicine. She completed her residency in anatomic and clinical pathology at the Brigham and Women’s Hospital, where she also served as chief resident. She then went on to complete a fellowship in breast pathology at Brigham and Women’s Hospital. Dr. Cleary is board certified in anatomic and clinical pathology. Her research interests include tumor heterogeneity and breast diseases.

Objectives

After this presentation, participants will be able to:

Discuss the clinical advantages for using neoadjuvant chemotherapy in certain breast cancer cases
Describe the relative rates of pCR following neoadjuvant chemotherapy for the different receptor subtypes of breast cancer
Apply appropriate sampling technique for neoadjuvant-treated breast cancer cases
Explain the different reporting systems for neoadjuvant-treated breast cancer cases and know how to apply them to individual cases