[Roles of the pathologist in neoadjuvant chemotherapy: evaluation of response, prognostic and predictive factors]

Induction chemotherapy is a therapeutic option for women presenting with invasive tumors over 3cm. This management is aimed to reduced tumor size in order to avoid mammectomy and to test the in vivo chemo sensitivity of the tumor cells. The pathologist plays a key role in optimal management of patients enrolled in induction chemotherapy trials. Evaluation of pretreatment biopsies contributes to establishment of key management parameters such as tumor type, SBR grade immunohistochemical parameters. This evaluation gives predictive parameters of drug response such as hormonal status, proliferation rate, HER2. The evaluation of the post treatment tumor residue helps in determinating tumor response to treatment, establishing prognosis and adjusting adjuvant regimens. Standard histopathological procedures are mandatory.