Changes of biomarkers expression between preoperative biopsy and after definitive surgical treatment in patients with invasive breast cancer who receive neoadjuvant chemotherapy

Abstract

Background Neoadjuvant systemic therapy has become a valuable strategy in the multidisciplinary treatment approach to breast cancer. There are conflicting results regarding the effect of neoadjuvant chemotherapy (NAC) on estrogen receptor, progesterone receptor, and human epidermal growth factor 2 (Her2) status in breast cancer. Aim The aim of this study was to shed some light on the effect of NAC on the biomarkers of breast cancer cells in patients with invasive cancer breast. Patients and methods A total of 22 female patients with breast mass that proved to be malignant by tru-cut biopsy underwent HR, Her2, and Ki67 assessments following administration of NAC and excision of the tumors, which were sent for histopathological assessment and assessment of the aforementioned markers. Changes were analyzed according to the type of the tumor, the grade, the hormone receptor status, and Her2 status of the tumor. These patients were managed in the General Surgery and Pathology Department, Faculty of Medicine, Benha University Hospital, during the period from January 2015 to June 2016. Results This study show that tumor cells that are hormone receptor negative and those that are Her2 positive are more sensitive to NAC with an obvious effect on proliferation index rate and higher rate of achieving complete pathological response. Infiltrating lobular carcinoma of the breast is associated with poorer response to NAC in comparison with duct carcinoma. The higher the grade of the tumor, the poorer the response to NAC. Conclusion The study shows that the breast cancer cells that are hormone receptors negative, Her2 positive, duct carcinoma, and lower grade tumors are more responsive to NAC.