Prognostic Value of the Pretreatment Neutrophil-to-Lymphocyte Ratio in Different Phenotypes of Locally Advanced Breast Cancer During Neoadjuvant Systemic Treatment

e11507 Background: It is reported that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may have the potential of predicting response to neoadjuvant chemotherapy (NAC) for patients with breast cancer and it is more accurate than the other radiologic methods. We aimed to compare the responses to NAC ± trastuzumab with DCE-MRI and histopathologic findings in locally advanced breast cancer. Methods: Between January 2007 and October 2011, 38 female patients patients with locally advanced breast cancer who recieved NAC ± trastuzumab and had whole breast DCE-MRI before / after treatment and who also had surgery after treatment were included in our study. Patients received 4 cycles of antracyclin based and 4 cycles of taxane based chemotherapy protocols sequentially. 9 patients with HER-2 (+) breast cancer also received trastuzumab with taxane based chemotherapy. Before and after NAC ± trastuzumab, tumor measurements were evaluated by mammography (MG), ultrasound (US), DCE-MRI and compared with postoperative histopathologic findings. Response rates were assessed with RECIST (Response Evolution Criteria in Solid Tumors) 1,1 criteria. MRI were done with 1,5 Tesla MR ( Gyroscan Achieva Intera, Philips ). SPSS 15.0 and Kappa test were used for statistical analysis. Results: After NAC ± trastuzumab, breast DCE-MRI revealed 13.2% complete response (CR), 73.7% partial response (PR), 10.5% stabile disease (SD), and 2.6% progressive disease (PD) and 15.8% CR, 73.7% PR, 7.9% SD and 2.6% PD were shown with histopathology. After neoadjuvant systemic treatment, histopathologic and DCE-MRI responses revealed high positive correlation with kappa test (kappa: 0,63), but there were low correlation between not only histopathologic and MG responses but also US responses with kappa test (kappa: 0,2). Conclusions: DCE-MRI is more effective method than other radiologic methods for the evaluation of response to NAC ± trastuzumab when compared with the histopathologic findings.

Download Full-text

The peculiarities of surgical service of locally advanced breast cancer after neoadjuvant systemic treatment

The Scientific Notes of the I P Pavlov St Petersburg State Medical University ◽

10.24884/1607-4181-2015-22-3-42-47 ◽

2015 ◽

Vol 22 (3) ◽

pp. 42-47

Author(s):

O. L. Petrenko

Keyword(s):

Breast Cancer ◽

Surgical Treatment ◽

Advanced Breast Cancer ◽

Systemic Treatment ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Radical Mastectomy ◽

Conservative Surgery ◽

Advanced Breast ◽

Treatment Stage

Patients with locally advanced (T2-4N0-3M0) breast cancer, receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery) were selected from the data base. The data of the first cancer register in the Russian Federation, disposing the data base for more than 5000 patients with breast cancer were analyzed in this work. Consistent with the primary goal of the work the information about 286 patients with locally advanced breast cancer (clinical stages IIB-IIB), receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery), was obtained from the date base. The follow up period is from 2 to 10 years. The estimation of application efficiency of neoadjuvant chemotherapy, hormonal treatment and target therapy was done. The basic clinical, pathomorphological and biological factors (HER2, ER, PR, degree of malignancy), decisive for planning of relevant neoadjuvant treatment, enabling to customize medical disposal for a patient and contributing to the increase of comprehensive treatment, rising of general and relapse free survival of patients with locally advanced breast cancer, who underwent breast-conserving surgeries.

Download Full-text