학술논문

Recommendations for standardized pathological characterization of residual disease for neoadjuvant clinical trials of breast cancer by the BIG-NABCG collaboration
Document Type
article
Source
Annals of Oncology. 26(7)
Subject
Biomedical and Clinical Sciences
Oncology and Carcinogenesis
Clinical Research
Breast Cancer
Cancer
Antineoplastic Combined Chemotherapy Protocols
Breast Neoplasms
Chemotherapy
Adjuvant
Clinical Trials as Topic
Female
Humans
Neoadjuvant Therapy
Neoplasm Staging
Neoplasm
Residual
Practice Guidelines as Topic
Prognosis
breast cancer
neoadjuvant systemic therapy
residual disease
pathologic complete response
pathologic assessment
response evaluation
Breast International Group-North American Breast Cancer Group (BIG-NABCG) collaboration
Oncology & Carcinogenesis
Clinical sciences
Oncology and carcinogenesis
Language
Abstract
Neoadjuvant systemic therapy (NAST) provides the unique opportunity to assess response to treatment after months rather than years of follow-up. However, significant variability exists in methods of pathologic assessment of response to NAST, and thus its interpretation for subsequent clinical decisions. Our international multidisciplinary working group was convened by the Breast International Group-North American Breast Cancer Group (BIG-NABCG) collaboration and tasked to recommend practical methods for standardized evaluation of the post-NAST surgical breast cancer specimen for clinical trials that promote accurate and reliable designation of pathologic complete response (pCR) and meaningful characterization of residual disease. Recommendations include multidisciplinary communication; clinical marking of the tumor site (clips); and radiologic, photographic, or pictorial imaging of the sliced specimen, to map the tissue sections and reconcile macroscopic and microscopic findings. The information required to define pCR (ypT0/is ypN0 or ypT0 yp N0), residual ypT and ypN stage using the current AJCC/UICC system, and the Residual Cancer Burden system were recommended for quantification of residual disease in clinical trials.