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Purpose of the study. Evaluation of the diagnostic value of vacuum-assisted biopsy (VAB) based on pathomorphological studies in patients with breast cancer (BC) who have achieved a complete clinical response (cCR) after neoadjuvant polychemotherapy (NACT).Patients and methods. In the study, conducted from 2021 to 2023 at the P. A. Hertsen Moscow Oncology Research Institute – a branch of the National Medical Research Radiology Center of the Ministry of Health of Russia, 35 patients with BC cT1–3N0–3M0 of various molecular-biological types who were diagnosed with cCR after NACT were included. All patients underwent VAB (needle size 7–10 G) of the breast followed by histological examination, after which surgical treatment was performed. Subsequently, histological conclusions of VAB and surgical materials were compared with each other for the presence and degree of pathomorphological response.Results. According to the pathomorphological conclusion when conducting VAB, the following results were obtained: 1 – true positive, 29 – true negative, 3 – false negative, and 0 – false positive. No statistically significant results of the association between complete pathomorphological response and the molecular-biological type of breast cancer were obtained (p > 0.05), however, there is a tendency towards the greatest number of complete pathomorphological responses in Her2-neu-positive (luminal – 100 %, non-luminal – 90.9 %) and triple-negative (87.50 %) types of breast cancer. The overall sensitivity of the method was 25.0 % (CI 6.8–60.2 %); specificity – 100 % (CI 88.1–100 %); false-negative result (presence of tumor cells in the surgical material and a negative result of VAB) – 9.1 % (CI 3.4–20.2 %); false-positive result (absence of tumor cells in the surgical material and a positive result of VAB) – 0 % (CI 0–10.6 %). The overall diagnostic accuracy of the method was 90.9 % (CI 79.8–96.6 %).Conclusion. The results of the conducted research allow for the consideration of excluding surgical treatment when a complete pathomorphological response is obtained by VAB. However, further research is required with the inclusion of a larger number of patients.

The paper is based on the retrospective analysis of 1033 history records of the patients treated for diagnosed tubular, mucous, papil- lary, medullary, or metaplastic carcinomas in the clinics of the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 1985 to 2005. After primary therapy, the maximum overall survival in patients with tubular, mucous, or papil- lary carcinoma was 5 years in 90% of the patients and 10 years or more in 85%. That in patients with metaplastic carcinoma was 5 years only in 65% and 10 years or more in less than 50%. Moreover, a negative status in terms of steroid hormone receptors was detect- ed most frequently in this form of carcinoma (p < 0.05) and HER-2/neu hyperexpression in 20% of cases (p < 0.002). Any radical surgical intervention for all rare breast carcinomas assures that more than 80% will survive 10 years and, if not any, will only 60% of the patients (p < 0.001).

The study used the records of clinical observations of 145 patients with locally advanced T3–Т4N0M0 breast cancer (BC) who were treated at the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 1998 to 2003. Based on the examined combination of prognostic factors, the authors identified the criteria that had the greatest impact on the prognosis of primary T3–Т4N0M0 BC, which must the standard for its determination in this category of patients.