Significance of Neoadjuvant Chemotherapy for Breast Cancer; Prediction of Prognosis according to Pathological Response

Abstract

Aim:The aim of this study was to investigate possibility to predict prognosis of breast-cancer patients treated with neoadjuvant chemotherapy (NAC) according to pathological responses.Patients:The study included 178 women with T> 3 cm and/or node-positive breast cancer and who received NAC at this department.
Treatment:Twenty-seven patients(pts) were treated with Epirubicin and docetaxel (ET), 80 pts were treated with epirubicin and cyclophosphamide (EC) followed by docetaxel (DTX), and 71 pts were treated with EC followed by weekly paclitaxel (PTX) with or without trastuzumab (T).
Results and Discussion:Seventeen pts (10.3%) had pathological CR (pCR) in a narrow sense, and 27 pts(16.4%) had pCR in a wide sense including pDCIS. 5-year(y) disease-free survival(DFS) rate was 93.8% among patients with pCR in a narrow sense and 64.9% among those with non-pCR (p=0.0497). On the other hand, 5y DFS rate was 79.9% among those with pCR in a wide sense and 65.2% with non-pCR (p=0.0666). In a multivariate analysis, pCR in a narrow sense was an independent prognostic factor of DFS. The results show that pCR in a narrow sense was a surrogate marker of good prognosis for breast cancer underwent NAC.