Macroscopic and microscopic pathology review was used to assess the degree of @entity5 reduction after preoperative chemotherapy in 90 @entity1 with inflammatory and locally advanced @entity0 . Fifteen (17%) @entity1 had no evident residual macroscopic @entity5 on gross pathological examination, and 6 of these 15 had no @entity41 on microscopic review either. There was no significant difference in disease-free and overall survival between the six @entity1 with no microscopic disease and the nine @entity1 with only microscopic @entity66 but no residual macroscopic @entity5 . These 15 @entity1 with major reduction after induction chemotherapy had a longer disease-free survival (DFS) (median not reached at 5 yr) than the other 75 @entity1 with lesser degrees of @entity5 reduction (DFS = 22 mo; P less than 0.01). Clinical evaluation of response to chemotherapy was a less accurate predictor of outcome than was the pathological assessment of response. Complete clinical responders had a 4-yr DFS of 55%, whereas @entity1 with non macroscopic @entity41 following preoperative chemotherapy, less than one-half of whom had been judged to be a complete clinical responder, had a median DFS of greater than 60 mo and a 4-yr DFS of 75%. @entity1 whose mastectomy specimen had no macroscopic @entity66 had a 93% 5-yr survival compared to @entity1 with a less marked response to therapy who had a 5-yr survival of 30% (P less than 0.01). No pretreatment @entity1 or @entity5 -related variables correlated with the degree of @entity5 reduction following preoperative therapy. Achievement of a mastectomy specimen free of residual macroscopic @entity5 after preoperative chemotherapy is an excellent prognostic factor for a prolonged DFS and survival. This information should be considered in the selection of postoperative systemic therapy.

Pathological assessment of response to induction chemotherapy in XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual tumor'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
