Abstract
The adoption of neoadjuvant chemotherapy (NACT) for breast cancer (BC) is increasing. The need to repeat the biomarkers on a residual tumor after NACT is still a matter of debate. We verified estrogen receptors (ER), progesterone receptors (PR), Ki67 and human epidermal growth factor receptor 2 (HER2) status changes impact in a retrospective monocentric series of 265 BCs undergoing NACT. All biomarkers changed with an overall tendency toward a reduced expression. Changes in PR and Ki67 were statistically significant (p = 0.001). Ki67 changed in 114/265 (43.0%) cases, PR in 44/265 (16.6%), ER in 31/265 (11.7%) and HER2 in 26/265 (9.8%). Overall, intrinsic subtype changed in 72/265 (27.2%) cases after NACT, and 10/265 (3.8%) cases switched to a different adjuvant therapy accordingly. Luminal subtypes changed most frequently (66/175; 31.7%) but with less impact on therapy (5/175; 2.8%). Only 3 of 58 triple-negative BCs (5.2%) changed their intrinsic subtype, but all of them switched treatment. No correlation was found between intrinsic subtype changes and clinicopathological features. To conclude, biomarkers changes with prognostic implications occurred in all BC intrinsic subtypes, albeit they impacted therapy mostly in HER2 negative and/or hormone receptors negative BCs. Biomarkers retesting after NACT is important to improve both tailored adjuvant therapies and prognostication of patients.
Highlights
The indications for neoadjuvant chemotherapy (NACT) in breast cancer have been implemented since 2006 [1]
Patients with a pathological complete response (pCR) were excluded from the present study: pCR was determined according to the most widely accepted definition that considers the absence of residual invasive disease in the breast plus the absence of measurable disease in any axillary lymph node; the possible presence of carcinoma in situ was included in the definition since it has no impact in patient prognosis [9]
We included in our study patients with carcinomas
Summary
The indications for neoadjuvant chemotherapy (NACT) in breast cancer have been implemented since 2006 [1]. The adjuvant therapy regimen could be modulated based on response to NACT For these reasons, the adoption of NACT for breast cancer patients has substantially increased in our institution in the last few years. The adoption of NACT for breast cancer patients has substantially increased in our institution in the last few years Both NACT and adjuvant therapies are mainly based on the assessment of three biomarkers on tumor tissue from preoperative biopsies worldwide: estrogen receptors (ER), progesterone receptors (PR) and HER2 status [6,7]. The need to repeat these biomarkers after NACT is still a matter of debate, and currently, no univocal international guidelines regarding this topic have been introduced
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
