Abstract

BackgroundPathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). We analyzed the predictive clinical factors for pathological responses and survival outcomes in a cohort of Egyptian patients.MethodsWe evaluated the medical records of patients with breast cancer who received NCT in our academic institute. Survival curves were estimated with the Kaplan-Meier method. Cox proportional models were used for multiple regression analysis.ResultsOur cohort included 368 patients with a median age of 48 years (range 21–70). The median follow-up time was 3 years. The clinical tumor stage (T3–4) represented 58%, with 80% having positive axillary nodes. The luminal subgroup prevailed by 68%. The objective response rate (ORR) reached 78%, and 16% of patients achieved pCR. The clinical node stage and optimal chemotherapy were associated with higher ORR (p = 0.035 and p = 0.001, respectively). Predictors of pCR were clinical T-stage (p = 0.026), high Ki-67 index > 20 (p = 0.05), and receiving optimal chemotherapy (p = 0.014). The estimated 3-year disease free-survival (DFS) was 53%. Receptor status, achieving ORR, and pCR were associated with better DFS with hazard ratios of 0.56, p = 0.008; 0.38, p = 0.04; and 0.28, p = 0.007, respectively.ConclusionsLuminal tumors still draw benefit from neoadjuvant chemotherapy in terms of clinical response and breast conservative surgery. Treatment escalation to those who did not achieve pCR requires more investigation, given a higher recurrence rate in real-world experience.

Highlights

  • Pathological complete response is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC)

  • Besides its usefulness to downstage inoperable LABC and increased rates of conservative breast surgery in the operable cases, NCT proved to be Shohdy et al Journal of the Egyptian National Cancer Institute (2021) 33:39 an excellent platform for studying different prognostic factors for long-term outcomes, especially pathological complete response [4]. In this cohort of Egyptian breast patients treated at a single academic institute, we looked for clinicopathological criteria of our LABC patients to analyze rates of Pathological complete response (pCR) across different subtypes, predictors of these rates, and association with long-term disease outcomes

  • Baseline clinicopathological criteria we report on a cohort of 368 Egyptian LABC female patients

Read more

Summary

Introduction

Pathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). Besides its usefulness to downstage inoperable LABC and increased rates of conservative breast surgery in the operable cases, NCT proved to be Shohdy et al Journal of the Egyptian National Cancer Institute (2021) 33:39 an excellent platform for studying different prognostic factors for long-term outcomes, especially pathological complete response (pCR) [4]. In this cohort of Egyptian breast patients treated at a single academic institute, we looked for clinicopathological criteria of our LABC patients to analyze rates of pCR across different subtypes, predictors of these rates, and association with long-term disease outcomes

Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

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 call