Place du pathologiste dans la prise en charge néoadjuvante des cancers du sein [Neoadjuvant treatment of breast cancer: implications for the pathologist].

Détails

ID Serval
serval:BIB_E4DF1D8B95C9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Place du pathologiste dans la prise en charge néoadjuvante des cancers du sein [Neoadjuvant treatment of breast cancer: implications for the pathologist].
Périodique
Annales de Pathologie
Auteur(s)
Le Guellec S., Perallon R., Alunni J.P., Charitansky H., Leaha C., Gonzalez A.M., Chateau M.C., Simony-Lafontaine J., Jacot W., Gutowski M., Penault-Llorca F., Dalenc F., Lacroix-Triki M.
ISSN
0242-6498 (Print)
ISSN-L
0242-6498
Statut éditorial
Publié
Date de publication
2011
Volume
31
Numéro
6
Pages
442-454
Langue
français
Notes
Publication types: English Abstract ; Journal ArticlePublication Status: ppublish
Résumé
These past few years, neoadjuvant strategy has taken an increasing place in the management of breast cancer patients. This strategy is mainly indicated to obtain a tumour bulk regression allowing a breast conserving surgery in patients that otherwise would have undergone mastectomy. Of note, development of new chemotherapy agents and targeted therapies has critically helped in the progress of neoadjuvant strategy as it is currently associated with better pathological response rates. In this context, the pathologist is at the crossroad of this multidisciplinary process. First, he provides on the initial core needle biopsy the tumour pathological characteristics that are critical for the choice of treatment strategy, i.e. histological type, histological grade, proliferative activity (mitotic count and Ki67/MIB1 index labeling), hormone receptor status (oestrogen receptor and progesterone receptor) and HER2 status. Secondly, the pathologist evaluates the pathological response and the status of surgical margins with regards to the residual tumour on the surgical specimen after neoadjuvant treatment. These parameters are important for the management of the patient, since it has been shown that complete pathological response is associated with improved disease free survival. Several grading systems are used to assess the pathological response in breast and axillary lymph nodes. The most frequently used in France are currently the systems described by Sataloff et al. and Chevallier et al. In this review, we detail the different steps involving the pathologist in neoadjuvant setting, with special regards to the quality process and future perspectives such as emerging predictive biomarkers.
Pubmed
Web of science
Création de la notice
08/02/2012 8:28
Dernière modification de la notice
20/08/2019 16:08
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