[Recent therapeutic options and expectations to the pathologist].

Abstract

The treatment of patients with breast cancer has progressively become multidisciplinary. Considering that the establishment of standards of care for medical treatment is a process of building consensus by using the best available scientific evidence, multidisciplinary guidelines have been developed in Germany to promote better and more consistent management of breast cancer patients (www.krebsgesellschaft.de). These guidelines provide a framework for clinical decision-making and pathological assessment that gives clinically useful and prognostically significant information. The improvement of standards of care is subject to the definition of procedures at the interface between the different involved disciplines. The following topics at the surgery-pathology interface are critical for the optimal management of breast cancer and should be coordinated, especially with regard to breast conserving therapy: 1. Unequivocal marking of the tissue specimens by the surgeon in order to obtain proper orientation. 2. Intra-operative frozen sectioning. 3. Residual tumour (R) classification (UICC, 2002) and adequate distance to resection margins (for DCIS and invasive carcinomas). 4. Specific requirements on the pathological examination of surgical specimens after primary systemic treatment (neoadjuvant chemotherapy), i. e. the assessment of tumour response and the extent and distribution of tumour residues.