title: Pathologic changes in breast cancer after anti-estrogen therapy.
abstract: Breast cancer patients do not commonly receive anti-estrogens prior to surgical excision. We reviewed a cohort of patients who received preoperative anti-estrogen therapy after baseline biopsy and then had a repeat biopsy after several weeks on treatment. Patients with estrogen receptor positive tumors received anastrozole and fulvestrant in combination with gefitinib. Core needle biopsies were performed at day 1 and 21, and tumors were completely excised if operable at day 112. All patients were postmenopausal. Following treatment, tumors had degenerative changes including smudged nuclei, decreased nuclear size, intranuclear vacuoles, vacuolated cytoplasm, and increased cellular discohesion. In addition, increased tubule formation and intracytoplasmic lumina were seen in 6/9 cases (66.7%) and decreased mitotic rate was demonstrated in 7/9 cases (77.8%). These findings indicate increased differentiation of the tumor cells in response to anti-estrogen therapy and that may correlate with clinical response.
authors.affiliation: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Norasate
authors.initials: N
authors.lastname: Samarnthai
authors.forename: Richard
authors.initials: R
authors.lastname: Elledge
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Prihoda
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Suleiman
authors.initials: S
authors.lastname: Massarweh
authors.forename: I-Tien
authors.initials: IT
authors.lastname: Yeh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation / Q000187:drug effects; D003593:Cytoplasm / Q000187:drug effects; D004958:Estradiol / Q000031:analogs & derivatives / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D000077267:Fulvestrant; D006801:Humans; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use; D017698:Postmenopause; D011960:Receptors, Estrogen / Q000378:metabolism; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D004965:Estrogen Antagonists; D009570:Nitriles; D011960:Receptors, Estrogen; D014230:Triazoles; D000077267:Fulvestrant; D000077384:Anastrozole; D004958:Estradiol