Effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki-67 in Chinese breast cancer patients: A retrospective study of 525 patients.

Yu-Tuan Wu,Lu Gan,Wei Dai,Lin-Jie Lu,Kai-Nan Wu,Vishnu Prasad Adhikari,Xin Li,Ling-Quan Kong,Yan-Ling Shi

doi:10.7555/jbr.32.20170059

Abstract

This study was designed to investigate the effect of neoadjuvant chemotherapy on the expression of hormone receptors and Ki67 in Chinese female breast cancer patients. The expression of estrogen receptor (ER), progesterone receptor (PR) and Ki67 among 525 neoadjuvant chemotherapy cases was studied by immunohistochemistry. Differences between specimens made through preoperative core needle biopsy and excised tissue biopsy were observed. The positive rates of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy were 65.3% and 63.2%, 51.0% and 42.6%, 65.6% and 43.4%, respectively. The expression of ER, PR and Ki67 in core needle biopsy and excised tissue biopsy had no statistically significant difference. However, after neoadjuvant chemotherapy, the discordance rates of ER, PR and Ki67 were 15.2% (79/521), 26.9% (140/520) and 44.8% (225/502), respectively. The ER, PR and Ki67 status changed from positive to negative in 7.5% (39/521), 13.3% (69/520) and 21.1% (106/502) of the patients, whereas ER, PR and Ki67 status changed from negative to positive in 7.7% (40/521), 13.6% (71/520) and 23.7% (119/502) of the patients, respectively. These results showed that the status of some biomarkers changes after neoadjuvant chemotherapy and biomarker status needs to be reexamined to optimize adjuvant systemic therapy and better prognosis assessment.

Highlights

Breast cancer is the most common and deadly cancer among females[1]
Previous studies have reported that neoadjuvant chemotherapy affects biomarker status in breast cancer, so a question has been raised about how neoadjuvant chemotherapy modulates these markers
Discordance of the hormone receptor status ranged from 8% to 33% in breast cancer patients who received neoadjuvant chemotherapy

Summary

Introduction

Neoadjuvant chemotherapy, the primary systemic treatment, has become a standard treatment to shrink the tumor and improve the chance of breast conserving surgery for operable breast cancer patients, because it can increase disease-free survival. CLC number: R394-33, Document code: A The authors reported no conflict of interests. The hormone-dependent nature of breast cancer is the basis for endocrine therapy that benefits patients with positive estrogen receptor (ER) and progesterone receptor (PR)[6–7]. The results of several studies on the effect of neoadjuvant chemotherapy on biomarker status in breast cancer are conflicting[8–10]

Methods

Results

Conclusion