Abstract
Background: The values of biomarkers expression might be changed following neoadjuvant chemotherapy (NACT), but little is known about the change range and its relationship to prognosis. This study aimed to investigate the potential changes of biomarkers expression before and after neoadjuvant chemotherapy, then predicting the pathological response and prognosis to NACT. Methods: A total of 119 patients who were initially diagnosed of breast cancer and underwent neoadjuvant chemotherapy were included in the study. Miller-Payne grading system was used to evaluate the pathologic response after neoadjuvant chemotherapy. Survival curves were estimated using the Kaplan-Meier method, and the log-rank test was used to test for differences between groups. Results: The high expression of ER, PR and Ki67 pre-NACT, the biomarkers expression post-NACT is also high (All P values <0.05). We found that the change of biomarkers expression before and after chemotherapy were all considered as medium changes (range between 10 to 30), while only PR expression change after NACT were associated with distant disease-free survival ( P <0.001) and overall survival ( P =0.031,6). PR expression also related to pathologic response ( P =0.028) but not ER, HER2 and Ki-67. Furthermore, a total of 67 down regulated of Ki67 expression compared with 37 up regulated expression, the results showed that decreasing expression of Ki67 had fewer local recurrence compared with Ki67 increasing expression after NACT. Conclusions: Our research have provided the prognostic value of biomarkers expression change following the neoadjuvant chemotherapy. These findings might help optimize the choice of targeted therapy and improve the predictive effect to patient survival.
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