Ki -67 proliferative index as a predictive tool for axillary pathological complete response in node-positive breast cancer

Background: It is unknown whether patients with cytologically proven axillary node-positive breast cancer who achieve axillary pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) have comparable prognosis to patients with axillary pathological node-negative disease (pN-) without NAC. Methods: We retrospectively reviewed the data of patients with cytologically proven axillary node-positive disease who received NAC and those with axillary pN- without NAC for control between January 2007 and December 2012. We compared outcomes according to response in the axilla to NAC and between patients with axillary pCR and matched pairs with axillary pN- without NAC using propensity scores. Results: We included 596 patients with node-positive breast cancer who received NAC. The median follow-up period was 64 months. Patients with axillary pCR showed significantly better distant disease-free survival (DDFS) and overall survival (OS) than patients with residual axillary disease (both p < 0.01). There was no significant difference in DDFS and OS between patients with axillary pCR and matched pairs with axillary pN- without NAC. Conclusion: Axillary pCR was associated with improved prognosis. Patients with axillary pCR and matched pairs with axillary pN- without NAC had comparable outcomes. This information will be useful when considering the intensity of follow-up and adjuvant therapy.

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Abstract P3-07-04: A dedicated nomogram to predict nodal pathological complete response in node-positive breast cancer patients undergoing neoadjuvant chemotherapy

10.1158/1538-7445.sabcs19-p3-07-04 ◽

2020 ◽

Author(s):

Fabio Corsi ◽

Valentina Forlini ◽

Daniela Bossi ◽

Sara Albasini ◽

Marta Truffi ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Pathological Complete Response ◽

Complete Response ◽

Breast Cancer Patients ◽

Node Positive ◽

Positive Breast Cancer

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Predictors of Nodal Pathological Complete Response in Asian Women with Stage II–III Node-Positive Breast Cancer

Oncology ◽

10.1159/000513454 ◽

2021 ◽

pp. 1-6

Author(s):

Giacomo Montagna ◽

Yiwei Tong ◽

Mathilde Ritter ◽

Jeremy Levi ◽

Walter P. Weber ◽

...

Keyword(s):

Breast Cancer ◽

Lymphovascular Invasion ◽

Pathological Complete Response ◽

Complete Response ◽

Asian Women ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Factors Associated ◽

Node Positive ◽

Positive Breast Cancer

Background: Neoadjuvant chemotherapy (NAC) is increasingly used to treat node-positive (N+) breast cancer. Predictors of nodal pathological complete response (pCR) in Asian women are poorly described and there is variety in the management of the axilla after NAC. We evaluated predictors of nodal pCR and axillary management in a cohort of Asian N+ patients. Methods: Consecutive biopsy-proven N+ breast cancer patients treated with NAC were identified from the Shanghai Ruijin Hospital in China. Axillary lymph node dissection was performed on all patients, irrespective of the nodal response to NAC. Results: A total of 323 patients were included. Nodal pCR was achieved in 105 patients (33%), 15% of HR+/HER2– tumors, 38% of HR+/HER2+ tumors, 49% of HR–/HER2+ tumors, and 42% of HR–/HER2–tumors (p < 0.001). Factors associated with nodal pCR were (1) receptor status (HR+/HER2– [referent]: OR 3.42, 95% CI 1.43–8.16, p = 0.006 for HR+/HER2+; OR 4.19, 95% CI 1.85–9.50, p = 0.001 for HR–/HER2+; and OR 2.94, 95% CI 1.11–7.74, p = 0.029 for HR–/HER2–), (2) breast pCR (no pCR [referent]: OR 15.22, 95% CI 6.29–36.79, p < 0.001), and (3) absence of lymphovascular invasion (LVI [referent]: OR 9.04, 95% CI 2.09–39.18, p = 0.003). Conclusion: This study confirmed expected predictors of nodal pCR in Asian women and the benefit of NAC in downstaging the axilla independently of ethnicity.

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Predictive factors of an axillary pathological complete response of node-positive breast cancer to neoadjuvant chemotherapy

Surgery Today ◽

10.1007/s00595-019-01858-x ◽

2019 ◽

Vol 50 (2) ◽

pp. 178-184 ◽

Cited By ~ 1

Author(s):

Naoko Iwamoto ◽

Tomoyuki Aruga ◽

Shinichiro Horiguchi ◽

Chiaki Saita ◽

Mai Onishi ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Predictive Factors ◽

Pathological Complete Response ◽

Complete Response ◽

Node Positive ◽

Positive Breast Cancer

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Rate and predictors of nodal pathological complete response following neoadjuvant endocrine treatment in clinically biopsy-proven node-positive breast cancer patients

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.04.041 ◽

2021 ◽

Author(s):

Robert-Jan Schipper ◽

Anne de Bruijn ◽

Adri C. Voogd ◽

Johanne G. Bloemen ◽

Yvonne E. Van Riet ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Pathological Complete Response ◽

Complete Response ◽

Endocrine Treatment ◽

Breast Cancer Patients ◽

Node Positive ◽

Positive Breast Cancer

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Neo-Family History Score Is A Novel Biomarker of Pathological Complete Response, Safety, and Survival Outcomes In Patients With Breast Cancer Receiving Neoadjuvant Platinum-Based Chemotherapy: A Retrospective Analysis of Two Prospective Trials

10.21203/rs.3.rs-320211/v1 ◽

2021 ◽

Author(s):

Yaqian Xu ◽

Yanping Lin ◽

Yifan Wu ◽

Yaohui Wang ◽

Liheng Zhou ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Family History ◽

Pathological Complete Response ◽

Complete Response ◽

Survival Outcomes ◽

Receptor Status ◽

Node Positive ◽

Kaplan Meier ◽

Platinum Based Chemotherapy

Abstract Background: Homologous recombination repair gene mutations are associated with increased platinum-based chemosensitivity, whereas few studies have reported the predictive value of family history of cancer for breast cancer in the neoadjuvant setting. This study aimed to construct a brief and effective novel family history scoring system and explore its association with pathological complete response (pCR), survival outcomes, and safety for locally advanced breast cancer receiving platinum-based neoadjuvant chemotherapy.Methods: A total of 262 patients treated with neoadjuvant cisplatin and paclitaxel were included. Neo-Family History Score (NeoFHS) was calculated according to cancer type, age at diagnosis, kinship, and number of affected relatives. Logistic regression was performed to analyze the association between pCR and NeoFHS. Survival rates were compared by Kaplan-Meier curves, examined by log-rank test and Cox proportional hazard regressions.Results: For all patients enrolled in this study, clinical tumor stage (p=0.048), estrogen receptor status (p=0.001), progesterone receptor status (p=0.036), human epidermal growth factor receptor 2 (HER2) status (p=0.013), and molecular subtype (p=0.016) were significantly related to NeoFHS. The multivariate logistic regression revealed that NeoFHS is an independent predictive factor of pCR (OR=2.262, 95% CI 1.159-4.414, p=0.017), especially in node-positive (OR=3.088, 95% CI 1.498-6.367, p=0.002), hormone receptor-positive (OR=2.645, 95% CI 1.164-6.010, p=0.020), and HER2-negative subgroups (OR=4.786, 95% CI 1.550-14.775, p=0.006). Kaplan-Meier estimates suggested that NeoFHS could serve as an independent prognostic factor for relapse-free survival in the whole group (adjusted HR=0.305, 95% CI 0.102-0.910, p=0.033) and node-positive subgroup (adjusted HR=0.317, 95% CI 0.103-0.973, p=0.045). Furthermore, alopecia (p=0.001), nausea (p=0.001), peripheral neuropathy (p=0.018), diarrhea (p=0.026), constipation (p=0.037) of any grade and leukopenia of grade 3 or greater (p=0.005) were more common in patients with higher NeoFHS.Conclusions: Our study revealed that NeoFHS is a practical and effective biomarker for predicting not only pCR and survival outcomes but also chemotherapy-induced AEs for neoadjuvant platinum-based chemotherapy for breast cancer. It may help screen candidate responders and guide safety managements in the future.

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