Histopathological Changes in Breast Cancers Following Neoadjuvant Chemotherapy: Implications for Assessment of Therapy-Induced Cytological and Stromal Changes for Better Clinical Outcome and Effective Patient care
Bibliographic record
Abstract
Abstract The histopathological interpretation of a tumor still remains the gold standard for diagnosis and deciding the type of therapy. Furthermore, in the context of chemo-radio-therapies often leading to prominent cytological and stromal changes in the tumor, histopathological interpretation during treatment, thus, becomes all the more important in correctly diagnosing and grading the tumor for an effective and planned regimen of the therapy increasing prognosis and chances of survival of the affected patients. The aim of the present study was to evaluate such cytological and stromal changes rendered by the therapy during treatment in breast cancer cases. The present study was conducted over a period of 4 years from January 2014 to June 2017 at Kasturba Medical College, Mangalore, Karnataka, India wherein the clinical and histopathological details were collected for a total of 39 breast carcinoma cases during and post-therapy. Statistical analysis was done using IBM SPSS statistics 17 (Chicago, USA). Various morphological features were analyzed for their frequency and were compared with the final diagnosis using Chi-square value (χ2), paired t-test and Fischer's test. p-value < 0.05 was considered to be statistically significant. The results of the present study revealed that 32 of the 39 breast carcinoma cases changed their grades during the course of therapy (p-value < 0.05). The fundamental manifestation of the effect of therapy was an obvious decrease in tumor cellularity. Intracellular changes commonly noted after chemotherapy included nuclear enlargement, hyperchromasia and an increased N:C ratio which were found in upto 85% of the cases followed by presence of prominent nucleoli and karyorrhexis/karyolysis. The predominant stromal changes seen post-therapy included necrosis (74.4%), fibrosis (64.1%), desmoplasia (59%) and degenerative changes (33.3%). Breast cancer therapy causes morphological alterations in the cancerous as well as the surrounding healthy tissue. The histopathological interpretation in such cases, thus, requires a thorough knowledge of the cytological and stromal changes rendered by the therapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".