Shrinkage mode of the primary breast tumor after neoadjuvant chemotherapy analyzed with part-mount sub-serial sectioning and three-dimensional reconstruction technique
10.3760/cma.j.issn.0253-3766.2016.04.006
- VernacularTitle:病理三维重建研究新辅助化疗后乳腺原发肿瘤的退缩模式
- Author:
Tao YANG
1
;
Zhaopeng ZHANG
;
Xiangyu SUN
;
Guang LIU
;
Dianbin MU
;
Yongsheng WANG
Author Information
1. 250117 济南，山东省医学科学院附属山东省肿瘤医院乳腺病中心; 222002 徐州医学院附属连云港市第一人民医院放疗科
- Keywords:
Breast neoplasms;
Antineoplastic combined chemotherpay protocols;
Pathology;
Microtome sectioning;
Imaging,three-dimensional reconstruction
- From:
Chinese Journal of Oncology
2016;38(4):270-276
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study is to evaluate the shrinkage mode of the primary tumor in women with breast cancer after neoadjuvant chemotherapy ( NAC ) determined by part?mount sub?serial section ( PMSS) and three?dimensional ( 3D) reconstruction technique. Methods Eighty?six women with pathologically proven solitary invasive ductal carcinoma (ⅡA?ⅢC) were recruited. They were divided into two groups. Group A ( n=25) received half cycles of NAC and Group B ( n=61) received whole cycles of NAC. Breast specimen was prepared with PMSS, and residual tumors were microscopically outlined, scanned and registered by Photoshop software. The 3D model of residual tumors was reconstructed with 3D?Doctor software to evaluate the shrinkage mode. Further, the clinicpathologic shrinkage modes were divided into 2 categories:concentric shrinkage mode ( CSM, the longest diameter of the pathological residual tumors was less than 50% and ≤2 cm in comparison with the primary tumor before NAC ) , and non?concentric shrinkage mode ( NCSM, the longest diameter of the pathological residual tumors was more than 50% and/or>2 cm in comparison with the primary tumor before NAC) . Results Pathological shrinkage modes:Group A: modes Ⅰ,Ⅱ, andⅤwere observed in 1, 1, and 23 cases, respectively;Group B:modesⅠ,Ⅱ,Ⅲ,Ⅳ, and Ⅴwere observed in 18, 3, 12, 21, and 7 cases, respectively ( P<0.001) . The multivariate analysis showed that patients with lower primary tumor stage, PR(-) or mammographic malignant calcification before NAC(-) and lymph nodes down?staging after NAC were more likely to present with CSM after NAC ( P<0.05 for all). Conclusions The pathologic reconstruction of breast residual tumors can fully and three?dimensionally reveal the shrinkage mode of the primary breast tumor in women with breast cancer after NAC. PMSS and 3D reconstruction of pathology provide a new platform in this area. Primary tumor stage, PR expression and mammographic malignant calcification before NAC and lymph node down?staging after NAC are independent predictors of the clinicopathologic shrinkage mode.
