Abstract
Background : Locally advanced breast cancers are nowadays treated with neoadjuvant chemotherapy (NAC) to downstage the tumor. One way to assess the NAC response is to use “Residual cancer burden index (RCB).” The aim of the study was to assess inter-pathologist reproducibility of residual cancer burden index and to evaluate different clinico-pathological parameters that determine the pathological response.
Methods: In this retrospective cohort study, surgically excised specimens of 49 NAC treated breast cancer were examined by histopathology and immunohistochemistry over a period of one and half years. Four pathologists with different level of experience reviewed the reports (unaware of original RCB index) and slides and assigned the RCB indices for each case. Clinical, histopathological and immunohistochemical parameters were evaluated.. Fleiss- Kappa statistics was applied to assess interobserver reproducibility of RCB index.
Results: No significant relationship was observed between RCB index (of original report) with age, largest tumor dimension and number of chemotherapy cycles . The RCB index of 49 cases as assigned by four pathologists was calculated by Fleiss-kappa statistics and it showed good overall agreement (82.6%).
Conclusion: It has been observed that there is no significant relation between pathological response to NAC with age, largest tumor dimension and number of chemotherapy cycles of breast carcinoma. It can also be concluded that RCB can be reliably used to report neoadjuvant chemotherapy treated specimens of breast cancer.
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References
Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, Wickerham DL, Begovic M, DeCillis A, Robidoux A, Margolese RG, Cruz AB Jr, Hoehn JL, Lees AW, Dimitrov NV, Bear HD. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 2023;41(10):1795-1808. doi: 10.1200/JCO.22.02571.
Peintinger F, Sinn B, Hatzis C, Albarracin C, Downs-Kelly E, Morkowski J, Gould R, Symmans WF. Reproducibility of residual cancer burden for prognostic assessment of breast cancer after neoadjuvant chemotherapy. Mod Pathol. 2015;28(7):913-20. doi: 10.1038/modpathol.2015.53.
Abrial C, Thivat E, Tacca O, Durando X, Mouret-Reynier MA, Gimbergues P, Penault-Llorca F, Chollet P. Measurement of residual disease after neoadjuvant chemotherapy. J Clin Oncol. 2008;26(18):3094; author reply 3095. doi: 10.1200/JCO.2008.16.7817.
Chollet P, Abrial C, Durando X, Thivat E, Tacca O, Mouret-Reynier MA, Leheurteur M, Kwiatkowski F, Dauplat J, Penault-Llorca F. A new prognostic classification after primary chemotherapy for breast cancer: residual disease in breast and nodes (RDBN). Cancer J. 2008;14(2):128-32. doi: 10.1097/PPO.0b013e31816bdea2.
Wang W, Liu Y, Zhang H, Zhang S, Duan X, Ye J, Xu L, Zhao J, Cheng Y, Liu Q. Prognostic value of residual cancer burden and Miller-Payne system after neoadjuvant chemotherapy for breast cancer. Gland Surg. 2021;10(12):3211-3221. doi: 10.21037/gs-21-608.
–Randolph JJ. Online Kappa Calculator [Computer software].2008 . Retrieved from http://www.justus.randolph.name/kappa
Sahoo S, Krings G, Chen YY, Carter JM, Chen B, Guo H, Hibshoosh H, Reisenbichler E, Fan F, Wei S, Khazai L, Balassanian R, Klein ME, Shad S, Venters SJ, Borowsky AD, Symmans WF, Ocal IT. Standardizing Pathologic Evaluation of Breast Carcinoma After Neoadjuvant Chemotherapy. Arch Pathol Lab Med. 2022;147(5):591-603. doi: 10.5858/arpa.2022-0021-EP. PMID: 35976643.
Sejben A, Kószó R, Kahán Z, Cserni G, Zombori T. Examination of Tumor Regression Grading Systems in Breast Cancer Patients Who Received Neoadjuvant Therapy. Pathol Oncol Res. 2020;26:2747-2754. doi: 10.1007/s12253-020-00867-3.
Lv Y, Li Y, Mu W, Fu H. Factors Affecting Pathological Complete Response After Neoadjuvant Chemotherapy in Operable Primary Breast Cancer. J Coll Physicians Surg Pak. 2020;30:389-393. doi: 10.29271/jcpsp.2020.04.389. PMID: 32513358.
Tang L, Shu X, TuG. Exploring the influencing factors of the pathologic complete response in estrogen receptor-positive, HER2-negative breast cancer after neoadjuvant chemotherapy: a retrospective study. World J SurgOnc 2022; 20: 27. https://doi.org/10.1186/s12957-022-02492-7
Jeon C, Kang SH, Kim SB, Paik NS, Lee I, Kim SK, Kim EY, Son GS, Yoo YB, Lee KH, Shin J, Ju S, Jang H, Park MH. Safety and Effectiveness of Trastuzumab Biosimilar SB3 in Korean Patients, a Post-Marketing Surveillance Study. Oncology. 2023; 27. doi: 10.1159/000534626.
Jin Y, Lan A, Dai Y, Jiang L, Liu S. Comparison of the pCR Rate and DFS Among Breast Cancer Patients with Different Hormone Receptor and HER2 Statuses. Breast Cancer (Dove Med Press). 2023 ;15:327-335. doi: 10.2147/BCTT.S407896.
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