Evaluation of histomorphological changes in breast cancer following neoadjuvant therapy at a tertiary care centre, Jharkhand

TL;DR

This study shows that neoadjuvant therapy significantly changes breast cancer tissue, helping predict treatment response and outcomes.

Contribution

The study provides empirical evidence of histomorphological changes in breast cancer after neoadjuvant therapy in a specific regional population.

Findings

Neoadjuvant therapy significantly reduced tumor cellularity and increased fibrosis in breast cancer patients.

Pathological complete response rates were highest in triple-negative and HER2-positive breast cancer subtypes.

High post-treatment tumor-infiltrating lymphocytes strongly correlated with better treatment response.

Abstract

Breast cancer remains a major cause of cancer-related mortality among women worldwide, with treatment response prediction posing a
persistent challenge. Neoadjuvant therapy (NAT) offers tumor downstaging and assessment of histopathological response. In this
prospective study of 125 patients, NAT led to a significant reduction in tumor cellularity (82.4% ± 12.3% to 31.7% ±
18.9%, p < 0.001) and increased fibrosis (15.2% ± 8.7% to 48.6% ± 15.4%, p < 0.001). Pathological complete response
(pCR) occurred in 32% of patients, with higher rates in triple-negative (42.1%) and HER2-positive (38.5%) subtypes. High post-NAT
tumor-infiltrating lymphocytes correlated strongly with pCR (r = 0.67, p < 0.001). Thus, we show that NAT induces significant
histomorphological changes, which can serve as key prognostic indicators for therapeutic response and patient outcomes.