The relationship between nucleolar markers in tru-cut biopsy specimens and response to neoadjuvant therapy and clinical-pathological parameters in breast cancer

Güneş H. Ş., Okcu O., Öztürk Ç.

38th European Congress of Pathology, Stockholm, İsveç, 12 - 16 Eylül 2026, cilt.489, ss.358, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 489
  • Basıldığı Şehir: Stockholm
  • Basıldığı Ülke: İsveç
  • Sayfa Sayıları: ss.358
  • Recep Tayyip Erdoğan Üniversitesi Adresli: Evet

Özet

Background & Objectives: Neoadjuvant chemotherapy (NAC) constitutes the Standard treatment for locally advanced breast cancer (BC). The subjective nature of routine nuclear grading, however, limits its predictive accuracy for treatment response. Nucleolar prominence may provide a more objective measure of nuclear activity and protein synthesis. This study assesses the capacity of nucleolar prominence to predict outcomes in diagnostic tru-cut biopsies and investigates its correlation with established prognostic factors. Methods: 232 BC patients who underwent NAC were retrospectively analysed. Nucleolar prominence was graded as Score 1 (small or inconspicuous nucleoli), Score 2 (noticeable nucleoli), and Score 3 (large or multiple prominent nucleoli). Treatment response wase valuated in the surgical specimens using the Miller-Payneand RCB systems. Correlation analysis was performed with clinical stage, nuclear grade (NG), ER, PR, HER2, and Ki-67 data. Results: A nucleolar structure with Score 1 was observed in 67 (28.9%) of the 232 patients, Score 2 in 114 (49.1%), and Score 3 in 51 (22.0%). No statistically significant association was found between the nucleolus score (NS)and treatment response. However, significant correlations were observed between nucleolus prominence and clinical stage (p=0.029), NG, ER status, and the Ki-67 proliferation index (p<0.05). In 43.3% of NG 3 tumours, NS was 3, whereas t), NGrate was 14.5% in NG 1–2 tumours. InallStage 3 tumours, NS was 2 or 3. Conclusion: Nucleolar prominence is not a significant predictive marker on its own for predicting the pathological response to neoadjuvant therapy. However, NS —a more concrete and reproducible parameter that can overcome subjectivity and low interobserver agreement in the assessment of nuclear pleomorphism—strongly correlates with tumour biological aggressiveness, clinical stage, and proliferative capacity. Therefore, using nucleolar prominence could provide a valuable contribution to enhancing prognostic objectivity in BC pathology.