scholarly journals A Case of Pure Mucinous Breast Carcinoma in a 25-Year-Old Female Who Showed Complete Pathological Response to Neoadjuvant Chemotherapy despite Poor Clinical Response

Breast Care ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 538-542
Author(s):  
Pei Du ◽  
Chunjie Hou ◽  
Jinglan Tang ◽  
Ying Liu ◽  
Qiaohong Hu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Maximum Diameter ◽  
Axillary Lymph ◽  
Histologic Subtype ◽  
Response To Chemotherapy ◽  
Response To Neoadjuvant Chemotherapy ◽  
Mucinous Breast Carcinoma

Introduction: Mucinous breast carcinoma is a rare histologic subtype of primary breast cancers accounting for 1–6%. It is a rare histological variant in young patients and usually presents without lymph node involvement, and its pathological response to neoadjuvant chemotherapy is rarely reported. Case Presentation: Pure mucinous breast carcinoma in a 25-year-old female was treated with neoadjuvant chemotherapy every 3 weeks for 8 cycles. After the fifth cycle, the mass size showed no change. We performed modified radical mastectomy in the left breast and axillary lymph node clearance. However, the pathological report showed a complete elimination of both the breast tumor and axillary lymph nodes, which were filled with mucus but did not contain malignant cells Discussion: Chemotherapy was profoundly effective against the tumor cells, but ineffective against large amounts of extracellular mucus. Even though the cancer cells were sensitive to chemotherapy, the volume of mucinous cancer couldnot be reduced. Conclusion: In summary, the evaluation criteria of tumor response to chemotherapy based on maximum diameter only should be considered insufficient for mucinous carcinoma.

scholarly journals SCD5 Expression Correlates with Prognosis and Response to Neoadjuvant Chemotherapy in Breast Cancer

2020 ◽  
Author(s):  
Weipeng Zhao ◽  
Linlin Sun ◽  
Xichuan Li ◽  
Jun Wang ◽  
Ye Zhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Cycle ◽  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Functional Enrichment ◽  
Integrated Analysis ◽  
Tumor Biomarker ◽  
Expression Signature ◽  
Response To Chemotherapy ◽  
Response To Neoadjuvant Chemotherapy

Abstract Neoadjuvant chemotherapy (NACT) represents a standard option for breast cancer. Unfortunately, about 55% to 80% of breast cancer patients do not have a favorable response to chemotherapy. Highly specific tumor biomarker that can predict the pathological response to neoadjuvant chemotherapy is lacking. Stearoyl-CoA desaturase 5 (SCD5) is an integral membrane protein of the endoplasmic reticulum that participates in lipid metabolism. However, the role of SCD5 in breast cancer remains unclear. Our study aims to understand its expression signature, prognosis value and correlation with pathological response to NACT in breast cancer using public databases. Analysis of samples from public databases showed that SCD5 expression was down-regulated across human cancers and associated with more aggressive breast cancer phenotypes. Survival analysis revealed that SCD5 expression was related to prognosis in breast cancer, especially triple-negative breast cancer (TNBC). Integrated analysis of multiple public datasets indicated that SCD5 expression signature was associated with response to NACT, particularly in TNBC. Based on functional enrichment analysis, SCD5 was implicated in pathways involved in metabolism and cell cycle. SCD5-related biological functions included negative regulation of cell cycle, cell division and DNA repair. Moreover, a significantly negative correlation between SCD5 expression and several cell cycle regulators was noted. Taken together, SCD5 was involved in the development and progression of breast cancer and might be a predictive biomarker for response to NACT. These results provided information for us to better understand SCD5 from the perspective of bioinformatics and highlighted the clinical importance of SCD5 in breast cancer, especially TNBC.

Novel surgical technique to selectively remove metastatic axillary lymph nodes in breast cancer patients after neoadjuvant chemotherapy: The MARI procedure—Marking of the axilla with radioactive iodine seeds.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 196-196
Author(s):  
Marie-Jeanne TFD Vrancken Peeters ◽  
Marieke Evelien Straver ◽  
Mila Donker ◽  
Claudette Loo ◽  
Gabe S. Sonke ◽  
...  
Keyword(s):  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Radioactive Iodine ◽  
Pathological Response ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Iodine 125

196 Background: An important benefit of neoadjuvant chemotherapy (NAC) is the increase in breast-conserving surgery. At present the response of axillary lymph node metastases to chemotherapy cannot be accurately assessed. Therefore axilla-conserving therapy is not yet a benefit. We aimed to assess a new surgical method to evaluate the axillary response: the MARI procedure, which stands for Marking of the Axillary lymph node with Radioactive Iodine seeds. Methods: Prior to NAC, proven tumor-positive axillary lymph nodes were marked with a Iodine-125 seed. After NAC, the marked lymph node was selectively removed with the use of a gamma-detection probe. A complementary axillary lymph node dissection was performed to assess whether pathological response in the marked node was indicative for the pathological response in the additional lymph nodes. Results: Tumor-positive axillary lymph nodes were successfully marked with Iodine-125 seeds in 68 patients. The marked lymph node (MARI-node) was surgically detected and selectively removed after NAC in all patients. The pathological response to chemotherapy in the MARI-node was indicative for the overall response in the additionally removed lymph nodes. In 47 patients the MARI-node contained residual disease (n=45 macrometastasis, n= 2 ITC). Thirty-five of them had macro- or micro metastases in the complementary axillary lymph node dissection specimen. In 21 patients the MARI-node was tumor negative. In 2 patients a macro metastasis was found in the additionally removed nodes, in 2 patients ITC were found and in the remaining 17 patients no residual tumor was found in the additionaly removed lymphnodes. (false negative rate of the MARI procedure: 9.5%). Conclusions: This study shows that marking and selectively removing metastatic lymph nodes after NAC is feasible. The tumor-response in the marked lymph node may be used to tailor further axillary treatment, and herewith enabling axilla-conserving surgery after neoadjuvant chemotherapy.

Development of Web Tools to Predict Axillary lymph Node Metastasis and Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Patients

2014 ◽  
Vol 29 (4) ◽  
pp. 372-379 ◽  
Author(s):  
Masahiro Sugimoto ◽  
Masahiro Takada ◽  
Masakazu Toi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Decision Tree ◽  
Cancer Patients ◽  
Axillary Lymph Node ◽  
Missing Values ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Response To Neoadjuvant Chemotherapy

Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree–based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of “unknown,” to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets.

scholarly journals Assessment of pathological response to neoadjuvant chemotherapy in patients with breast carcinoma using Sataloff system

2019 ◽  
Vol 25 (2) ◽  
pp. 13-18
Author(s):  
Savita Agarwal ◽  
Pinki Pandey ◽  
Megha Ralli ◽  
Vineet Chaturvedi ◽  
Kailash Mittal ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Residual Disease ◽  
Locally Advanced ◽  
Pathological Response ◽  
Pathological Examination ◽  
Response To Neoadjuvant Chemotherapy

Background: Neoadjuvant chemotherapy is frequently administered to patients with breast carcinoma. Response to chemotherapeutic regime can be assessed clinically as well as by pathological examination of the breast tissue. It is essential to accurately categorize the patients with residual disease according to the standard guidelines for pathological evaluation of breast specimens after neoadjuvant chemotherapy. The present study was undertaken to assess the histomorphological changes in mastectomy specimens and axillary lymphatic nodes of patients receiving neoadjuvant chemotherapy, grade the pathological response using Sataloff system and to compare the clinical and pathological response after neoadjuvant chemotherapy. Methods: Present prospective study included a total of 31 patients with locally advanced breast carcinoma, diagnosed with infiltrating ductal carcinoma, not otherwise specified on biopsy specimen and subsequently treated with 2 to 6 cycles of neoadjuvant chemotherapy. Pathological response to neoadjuvant chemotherapy was assessed in breast and axillary lymphatic nodes according to Sataloff criteria. Results: Clinical response observed was complete (cCR) in four cases (12.9%), partial response (cPR) in 24 cases (77.4%), and no response (cNR) in three cases (9.7%). Based on tumor response, breast and lymph nodes were graded as pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR) in five (16.1%), 18 (58.1%) and eight (25.8%) cases respectively using Sataloff criteria. Ductal carcinoma in situ and lymphovascular invasion were seen in 11 (35.4%) and 16 cases (51.6%), respectively. Conclusion: The pathological assessment of tumor response remains the gold standard, as neither the clinical nor the radiological responses are sensitive predictors of tumor response after treatment. However pathological examination is quite challenging and demands sufficient experience along with detailed clinical and radiological data of pre- and postoperative neoadjuvant chemotherapy for precise response evaluation.

Sign in / Sign up

Export Citation Format

Share Document