Clinical significance of pathological response in the breast cancer after neoadjuvant chemotherapy

Abstract

OBJECTIVE Discuss the influential factor of pathologic response of tumor, axillary lymph nodes and extranodal soft tissue extension (ETE) in breast cancer after neoadjuvant chemotherapy and patients survival. 196 patients with II B to approximately III B stage breast cancer, all female, aged 47 (26-65), were treated by neoadjuvant chemotherapy, including intravenous injection of docetaxel and epirubicin for 21 days, followed by surgery. Then follow-up was conducted for 61 months (4-70 months). The influential factor of pathological response and relation between pathologic response and survival were analyzed. The follow-up rate of the 196 patients was 100%. 20 patients (10.2%) achieved pathological complete response (pCR), 108 patients (55.1%) achieved pathological part response (pPR), and 68 patients (34.7%) achieved pathological stable disease pSD. There was no correlation between pCR and clinical staging, and age of patients (both P > 0.05). But there was a correlation between pCR and the size of tumor, estrogen receptor (ER), progesterone receptor (PR), and pathological type (all P < 0.01). 27.0% of the metastatic axillary lymph-nodes showed down-staging. The overall 5-year survival rate was 62.8% (P < 0.01). The median period of survival was 61 month (P < 0.01). pCR is correlated with the size of tumor, ER, PR, and pathological type. Down-staging of primary tumor and metastatic axillary lymph-node are important prognosis factors.