Neoadjuvant chemotherapy is increasingly being offered to patients with invasive breast carcinoma but surgical excision specimens following such therapy may be difficult to interpret in the pathology laboratory, both macroscopically and histologically. We provide here some guidelines for handling such postneoadjuvant chemotherapy samples and describe the histopathological features which may be encountered in both the breast and lymph nodes received. We also present a brief review of the literature and suggest a simple method for quantifying the degree of response to neoadjuvant chemotherapy in both the primary breast carcinoma and the lymph nodes.