Abstract

The aim of this study was to evaluate the probability of pathologic complete regression (pCR) by the BRCA1 gene mutation status in patients with triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy. The study involved 143 women (mean age 55.4 ± 13.1 years) with TNBC. The BRCA1 mutation was observed in 17% of the subjects. The most commonly used (85.3%) chemotherapy regimen was four cycles of adriamycine and cyclophosphamide followed by 12 cycles of paclitaxel (4AC + 12T). The differences between clinico-pathological factors by BRCA1 status were estimated. Odds ratios and 95% confidence intervals for pCR vs. non-pCR were calculated using logistic regression. The probability distribution of pCR based on BRCA1 status was estimated using beta distributions. The presence of T3–T4 tumours, cancer in stages II and III, lymphovascular invasion, and the use of chemotherapy schedules other than 4AC + 12T significantly decreased the odds of pCR. It was established that there was a 20% chance that pCR in patients with the BRCA1 mutation was 50% or more times as frequent than in patients without the mutation. Thus, the BRCA1 mutation can be a predictive factor for pCR in patients with TNBC.

Highlights

  • The aim of this paper is to evaluate the probability of pathologic complete regression (pCR) in triplenegative breast cancers patients, treated mostly with the recommended, neoadjuvant schedule AC followed by taxane chemotherapy, based on BRCA1 gene mutation status

  • The study involved 143 women treated with neoadjuvant systemic treatment for triple-negative breast cancer between 2015 and 2019.The method to determine ER, PgR, and HER2 negativity was used according to the American Society of Clinical Oncology, College of American Pathologists guidelines: ER and PgR nuclear staining of less than 1% by immunohistochemistry (IHC) and HER2 IHC staining of 0 to 1+ or fluorescent in situ hybridization

  • Only two randomized trials reported pCR results according to germline BRCA mutational status [23,27]. Pooled results from these trials showed that the addition of carboplatin to paclitaxel followed by anthracycline plus cyclophosphamide was not associated with a significant increased pCR rate in BRCA-mutated breast cancer patients

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Summary

Objectives

The aim of this study was to evaluate the probability of pathologic complete regression. The aim of this paper is to evaluate the probability of pCR in triplenegative breast cancers patients, treated mostly with the recommended, neoadjuvant schedule AC followed by taxane chemotherapy, based on BRCA1 gene mutation status

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