Effect of neoadjuvant treatment with anastrozole on tumour histology in postmenopausal women with large operable breast cancer.
Anastrozole is an orally active, non-steroidal aromatase inhibitor which appears effective as neoadjuvant treatment of breast cancer. Histological changes have been evaluated in biopsies from large, oestrogen-receptor rich, operable breast tumours in postmenopausal women following 12 weeks of neoadjuvant anastrozole treatment (1 mg (n=12) or 10 mg (n=11)). Of the 23 patients, 18 had a clinical response following treatment. Compared with pre-treatment biopsies anastrozole-treated specimens displayed decreased cellularity and/or increased fibrosis in 15 tumours; changes in gland formation, nuclear pleomorphism, or mitoses, in 12 cases; and a reduction in Mib1 score in all tumours. Marked changes in apoptotic scores were seen following treatment but the direction of effect was inconsistent. In all 17 tumours which were positive for progesterone receptors before therapy, treatment was associated with reduced staining for progesterone receptors. There was no consistent effect of treatment on oestrogen-receptor expression. It is concluded that neoadjuvant anastrozole treatment in this patient group has marked effects on tumour histopathology but these do not always correlate with clinical response.
Department of Pathology, Western General Hospital, Edinburgh EH4 2XU, UK.
T J
TJ
Anderson
J M
JM
Dixon
M
M
Stuart
T
T
Sahmoud
W R
WR
Miller
D000368:Aged; D000077384:Anastrozole; D034961:Antigens, Nuclear; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009570:Nitriles / Q000627:therapeutic use*; D009687:Nuclear Proteins / Q000032:analysis; D017698:Postmenopause; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D014230:Triazoles / Q000627:therapeutic use*
D034961:Antigens, Nuclear; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D009687:Nuclear Proteins; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014230:Triazoles; D000077384:Anastrozole