Patrones de recaída y respuesta patológica según tipo subrogado en pacientes con cáncer de mama y axila negativa al inicio tratadas con quimioterapia neoadyuvante

Abstract

PurposeTo determine relapse patterns and pathological response in relation to surrogate types of breast cancer after neoadjuvant treatment to analyse survival and optimize surveillance. Material and methodsRetrospective analysis of 112 patients with 116 tumours, with negative axillary involvement, treated with neoadjuvant chemotherapy at our hospital, between 2008 and 2014, who systematically underwent surgery. We analysed pathological response according to surrogate subtypes, rates and patterns of recurrence, disease free survival (DFS) and overall survival (OS). ResultsPathological complete response (pCR) was achieved in 52.6%, finding that these patients had better survival (p<.05). Looking at surrogate subtypes, we observed a pCR in 85% of pure Her-2/neu positive tumours, 65.6% of triple negatives, 43.8% of Her -2 positive Luminal B, 40% of Luminal B and 25% of Luminal A (p<.05). With a median follow-up of 53 months, we found a 9% rate of relapses. The less aggressive types had a median loco-regional relapse time of 38.5 months and a systemic recurrence time of 74 months. The more aggressive types showed a loco-regional relapse time of 36.2 months and systemic recurrence time of 8 months. ConclusionsNeoadjuvant chemotherapy according to surrogate type is a useful strategy to attempt pCR. Loco-regional relapse and systemic recurrence patterns allow surveillance adjustments.