Issues in the Assessment of the Pathologic Effect of Primary Systemic Therapy for Breast Cancer

DOI Web Site 被引用文献6件 参考文献91件
  • Kuroi Katsumasa
    Japan Breast Cancer Research Group Department of Surgery, Showa University Toyosu Hospital
  • Toi Masakazu
    Japan Breast Cancer Research Group Division of Clinical Trial and Research, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital
  • Tsuda Hitoshi
    Japan Breast Cancer Research Group Department of Pathology II, National Defense Medical College
  • Kurosumi Masafumi
    Japan Breast Cancer Research Group Department of Pathology, Saitama Cancer Center
  • Akiyama Futoshi
    Japan Breast Cancer Research Group Department of Breast Pathology, Cancer Institute

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Background: Emerging evidence suggests that induction of pathologic complete response (pCR) after primary systemic therapy (PST) is, at least to some extent, predictive of survival. However, standards for processing surgical specimens and for histopathologic evaluation of the pathologic response to therapy appear to be lacking.<BR> Methods: To perform a systematic review of representative articles on this topic, a computerized (MEDLINE) search was undertaken followed by a manual search based on the reference lists of the publications identified.<BR> Results: Several classification systems have been used to assess pathologic response to PST, the term pCR has not been applied in a consistent standardized manner, and only limited information is available about the reliability and validity of these classification systems. However, definitions of pCR can be summarized as follows: near pCR, only focal invasive tumor residues in the removed breast; quasi pCR, total or near total disappearance of invasive tumor in the removed breast; pCRinv, only in situ tumor residual in the removed breast; comprehensive pCR, no evidence of residual invasive tumor in the removed breast; strict pCR, disappearance of all tumor cells in the removed breast; comprehensive pCR br+n, no evidence of residual invasive tumor in the breast and axillary nodes; strict pCR br+n, no malignant tumor cells in the removed breast and axillary nodes. Comparison of the use of the term “ pCR ” in various trials reveals that it is not applied equivalently in these studies.<BR> Conclusion : Assessment of pCR needs to be standardized, with verification for reliability and validity. For now, the non-equivalency in the definition of pCR should be taken into account when comparing the results of PST.

収録刊行物

  • Breast Cancer

    Breast Cancer 13 (1), 38-48, 2006

    日本乳癌学会

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