Do breast cancer tumours downsize as well as downgrade with neoadjuvant chemotherapy?
© BioMed Central Ltd 2007
Received: 23 May 2007
Published: 19 June 2007
Neoadjuvant chemotherapy (NC) is increasingly being used for large primary breast carcinomas with the aim of improving breast-conservation surgery (BCS) rates. This study was conducted to assess the tumour response following NC.
In this retrospective study over a 4-year period, 61 women with large operable invasive breast cancers (T2–4 N0–2 M0), unsuitable for BCS, were consecutively treated with NC (5-FU, epirubicin, cyclophosphamide and Taxotere). Pathological response was monitored, comparing original core biopsy histology with final excisional histology.
Initial histology (core)
Final histology designation (post NC)
No residual invasive cancer
In our series of patients receiving NC for breast cancer, there is not only a significant downsizing (permitting BCS) but also a trend of downgrading of the tumour, and this is seen particularly in poorly differentiated tumours. The higher grade on final histology compared with the core could be due to an unrepresentative core biopsy in large tumours prior to NC.