Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (1): 32-37.doi: 10.6040/j.issn.1671-7554.0.2017.1094

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Correlation between breast and axillary pathologic complete response after neoadjuvant chemotherapy

ZHU Jiujun, JIAO Dechuang, QIAO Jianghua, WANG Lina, MA Youzhao, YANG Yue, LU Zhenduo, LIU Zhenzhen   

  1. Department of Breast Surgery, Affiliated Cancer Hospital of Zhengzhou University;
    Henan Cancer Hospital, Zhengzhou 450008, Henan, China
  • Published:2022-09-27

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Abstract: Objective To investigate the risk and significance of axillary metastasis in patients who achieved breast pathologic complete response(pCR)after neoadjuvant chemotherapy(NAC). Methods The clinical data of 701 breast cancer cases treated with NAC during 5th March 2014 and 21st July 2017 were retrospectively analyzed. The relationship of axillary pCR(apCR)with clinicopathological characteristics and breast pCR(bpCR)was calculated using χ2 test. The correlation between the variables and apCR was analyzed with multivariate binary logistic regression. Results Lymph node staging, estrogen receptor(ER)and HER2 were independent predictors for apCR. Among bpCR patients who were HER2 positive and cN0, 93% had no nodal metastasis(14/15), and 6 of 7 cases had an apCR in basal-like, cN0 group. The aPCR rate in the cN1 group were 67%. Among Luminal A&B groups, 3 and 17(60%, 40%)patients with cN0 disease, while 8 and 20(47%, 27%)patients with cN1 disease had an apCR. Compared with patients with bpCR, those without bpCR had 4.53 times higher risk of positive nodal metastases. Conclusion The nodal status is highly correlated with bpCR after neoadjuvant chemotherapy. Patients with cN0/1 who are HER2 positive and BL subtype patients with cN0 have low risk of nodal metastases if they achieve bpCR after neoadjuvant chemotherapy.

Key words: Breast cancer, Neoadjuvant chemotherapy, Axillary lymph node, Pathologic complete response

CLC Number: 

  • R737.9
[1] Mamounas EP, Brown A, Anderson S, et al. Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: Results from national surgical adjuvant breast and bowel project protocol b-27[J]. J Clin Oncol, 2005, 23(12): 2694-2702.
[2] Gianni L, Eiermann W, Semiglazov V, et al. Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with her2-positive locally advanced breast cancer(the noah trial): A randomised controlled superiority trial with a parallel her2-negative cohort[J]. Lancet, 2010, 375(9712): 377-384.
[3] Buzdar AU, Valero V, Ibrahim NK, et al. Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil, epirubicin, and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer: An update of the initial randomized study population and data of additional patients treated with the same regimen[J]. Clin Cancer Res, 2007, 13(1): 228-233.
[4] van la Parra RF, Kuerer HM. Selective elimination of breast cancer surgery in exceptional responders: Historical perspective and current trials[J]. Breast Cancer Res, 2016, 18(1): 28.
[5] Pilewskie M, Morrow M. Axillary nodal management following neoadjuvant chemotherapy: A review[J]. JAMA Oncol, 2017, 3(4): 549-555.
[6] Edge SB, Byrd DR, Compton CC, et al. AJCC Cancer Staging Manual, 7th Edition[M]. New York: Springer, 2010.
[7] Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: Highlights of the st gallen international expert consensus on the primary therapy of early breast cancer 2013[J]. Ann Oncol, 2013, 24(9): 2206-2223.
[8] Vera-Badillo FE, Templeton AJ, de Gouveia P, et al. Androgen receptor expression and outcomes in early breast cancer: A systematic review and meta-analysis[J]. J Natl Cancer Inst, 2014, 106(1): 319.
[9] Cortazar P, Zhang L, Untch M, et al. Pathological complete response and long-term clinical benefit in breast cancer: The ctneobc pooled analysis[J]. Lancet, 2014, 384(9938): 164-172.
[10] Hennessy BT, Hortobagyi GN, Rouzier R, et al. Outcome after pathologic complete eradication of cytologically proven breast cancer axillary node metastases following primary chemotherapy[J]. J Clin Oncol, 2005, 23(36): 9304-9311.
[11] Bayraktar S, Gonzalez-Angulo AM, Lei X, et al. Efficacy of neoadjuvant therapy with trastuzumab concurrent with anthracycline- and nonanthracycline-based regimens for her2-positive breast cancer[J]. Cancer, 2012, 118(9): 2385-2393.
[12] Untch M, Fasching PA, Konecny GE, et al. Pathologic complete response after neoadjuvant chemotherapy plus trastuzumab predicts favorable survival in human epidermal growth factor receptor 2-overexpressing breast cancer: Results from the techno trial of the ago and gbg study groups[J]. J Clin Oncol, 2011, 29(25): 3351-3357.
[13] Zhang GC, Zhang YF, Xu FP, et al. Axillary lymph node status, adjusted for pathologic complete response in breast and axilla after neoadjuvant chemotherapy, predicts differential disease-free survival in breast cancer[J]. Curr Oncol, 2013, 20(3): 180-192.
[14] Saxena N, Hartman M, Aziz R, et al. Prognostic value of axillary lymph node status after neoadjuvant chemotherapy. Results from a multicentre study[J]. Eur J Cancer, 2011, 47(8): 1186-1192.
[15] Stoetzer OJ, Fersching DM, Salat C, et al. Circulating immunogenic cell death biomarkers hmgb1 and rage in breast cancer patients during neoadjuvant chemotherapy[J]. Tumour Biol, 2013, 34(1): 81-90.
[16] Ohno S, Chow LW, Sato N, et al. Randomized trial of preoperative docetaxel with or without capecitabine after 4 cycles of 5-fluorouracil- epirubicin-cyclophosphamide(fec)in early-stage breast cancer: Exploratory analyses identify ki67 as a predictive biomarker for response to neoadjuvant chemotherapy[J]. Breast Cancer Res Treat, 2013, 142(1): 69-80.
[17] Nwaogu IY, Fayanju OM, Jeffe DB, et al. Predictors of pathological complete response to neoadjuvant chemotherapy in stage ii and iii breast cancer: The impact of chemotherapeutic regimen[J]. Mol Clin Oncol, 2015, 3(5): 1117-1122.
[18] Kuerer HM, Rauch GM, Krishnamurthy S, et al. Abstract p5-16-30: Feasibility trial for identification of patients for eliminating breast cancer surgery following neoadjuvant systemic therapy[J]. Cancer Research, 2017, 77(4 Supplement): P5-16-30.
[19] Tadros AB, Yang WT, Krishnamurthy S, et al. Identification of patients with documented pathologic complete response in the breast after neoadjuvant chemotherapy for omission of axillary surgery[J]. JAMA Surg, 2017, 152(7): 665-670.
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