Klin Onkol 1995; 8(5): 153-154.
Summary: Preoperative chemotherapy permits new approaches for evaluating early indicators of tumor response. Fine-needle cytopuncture is an easy sampling method providing cellular material to study morphologic and biologic parameters before and during treatment by means of cytologic examination, cell image analysis and flow cytometry. We report the results of a study undertaken on a group of 94 patients with large primary operable breast carcinoma (T2 > 30 mm, T3) treated by anthra-cycline-based preoperative cheotherapy followed by total or partial mastectomy with axillary dissection. Pretreatment tru-cuts and sequential fine-needle cytopunctures before and after aeach cycle of chemotherapy were analyzed by cytomorphology, image cytometry and DNA flow cytometry. Two main difficulties are encountered in this kind of study - the uncertainties in assessment of some tumor regressions and the tumor heterogeneity in large breast carcinomas. Despite these difficulties, before treatment, it seems possible to select non-responsive tumors to anthracyclin therapy with low-nuclear grade and low S-pha-se. For these tumors we can not expect tumor regression and probably the alternative treatment would be surgery first. For the other tumors, a second step selection could be possible after one cycle of chemotherapy. For tumor without cytomorphologic and cell kinetic changes it would be logical to test a non-cross resistant chemotherapy. All cases with pathologic complete regression had shown early changes in DNA profiles.
