{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:12:14Z","timestamp":1747185134300,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Neoadjuvant chemotherapy (NAC) is frequently used for the treatment of breast cancer. We sought to analyse the clinical, morphological and immunohistochemical features of tumours from patients who did not achieve pathological complete response following NAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We identified stage I\u2013III post\u2010NAC breast cancers from surgical resections (2000\u20132016) with evaluable residual invasive carcinoma [ypT1a(m) or greater and \u226515% tumour cellularity]. One hundred and forty\u2010three tumours from 142 patients were included. On univariable analysis, a high (score 3) post\u2010NAC mitotic score (as compared with 1 or 2) was significantly associated with invasive ductal carcinoma (IDC) subtype (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.023), high grade, pushing borders with zones of necrosis, hormone receptor and triple\u2010negative status, lack of hormonal therapy, higher cellularity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and a higher percentage of tumour\u2010infiltrating lymphocytes (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.016). Multivariable analysis showed a high post\u2010NAC mitotic score to be significantly associated with recurrence, distant metastasis, and shortened survival (hazard ratios of 5.73, 4.49, and 3.68, respectively). High post\u2010NAC mitotic score tumours (<jats:italic>n<\/jats:italic>\u00a0=\u00a032) were IDC and had a high Ki67 proliferation index (median, 55%). Of these, 24 (75%) had pushing borders with zones of necrosis; 19 (79.2%) of these had necrosis on preoperative imaging, and 24 (75%), 15 (46.9%) and four (12.5%) lacked androgen receptor, GATA\u20103 and cytokeratin 18 expression, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High post\u2010NAC mitotic score breast cancers cause high morbidity and mortality, frequently have pushing borders and zones of necrosis, and may show loss of common \u2018breast cancer markers\u2019. Our findings support that necrosis in pretreatment studies and post\u2010NAC mitotic score should be routinely reported, as they offer significant additional prognostic information to guide management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14049","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T04:39:53Z","timestamp":1576643993000},"page":"661-670","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A high mitotic score in breast cancer after neoadjuvant chemotherapy is predictive of outcome and associated with a distinct morphology"],"prefix":"10.1111","volume":"76","author":[{"given":"Karen R","family":"Arispe Angulo","sequence":"first","affiliation":[{"name":"Department of Pathology Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeeshan","family":"Jawa","sequence":"additional","affiliation":[{"name":"Cancer Center of Iowa Des Moines IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Visotcky","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shadie S","family":"Majidi","sequence":"additional","affiliation":[{"name":"Department of Radiology Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R","family":"Chitambar","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Hematology and Oncology Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-6670","authenticated-orcid":false,"given":"Julie M","family":"Jorns","sequence":"additional","affiliation":[{"name":"Department of Pathology Medical College of Wisconsin Milwaukee WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1245\/s10434-011-2108-2"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1200\/JCO.2011.38.8595"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1158\/1078-0432.CCR-06-1109"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1200\/JCO.2007.14.4147"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1158\/1078-0432.CCR-04-2421"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1016\/j.soc.2017.08.004"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1007\/s10549-013-2761-1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1093\/annonc\/mdu118"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1200\/JCO.2011.39.2779"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1093\/annonc\/mdq709"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1200\/JCO.2009.23.8303"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1200\/JCO.2005.05.078"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1007\/s10549-010-1103-9"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1200\/JCO.2018.78.7986"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1007\/s10549-018-4959-8"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1200\/JCO.2015.63.1010"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1007\/s10549-013-2411-7"},{"unstructured":"Residual cancer burden calculator.2014. 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