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Evaluation of Breast and Axillary Lymph Node Specimens in Breast Cancer Patients Treated With Neoadjuvant Systemic Therapy

Baker, Gabrielle M., MD*,†; King, Tari A., MD‡,§; Schnitt, Stuart J., MD§,∥

Advances in Anatomic Pathology: July 2019 - Volume 26 - Issue 4 - p 221–234
doi: 10.1097/PAP.0000000000000237
Review Articles

Breast and axillary lymph node specimens from breast cancer patients treated with neoadjuvant systemic therapy are being encountered by pathologists with increasing frequency. Evaluation of these specimens presents challenges that differ from those encountered during the examination of other types of breast specimens. This article reviews the key issues regarding the gross and microscopic evaluation of post-neoadjuvant systemic therapy breast and lymph node specimens, and emphasizes the importance of accurate specimen evaluation in assessing treatment response.

*Department of Pathology, Beth Israel Deaconess Medical Center

Department of Pathology, Harvard Medical School

Departments of Surgery (Surgical Oncology)

Pathology, Brigham and Women’s Hospital

§Dana-Farber Cancer Institute, Boston, MA

The authors have no funding or conflicts of interest to disclose.

All figures can be viewed online in color at

Reprints: Gabrielle M. Baker, MD, Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 (e-mail:

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