Prognosis of triple negative breast cancer patients receiving neoadjuvant chemotherapy versus adjuvant chemotherapy: a retrospective analysis

Abstract

Objective To compare the prognosis of triple-negative breast cancer patients receiving neoadjuvant chemotherapy versus adjuvant chemotherapy. Methods This retrospective study involved 214 patients with triple negative breast cancer in the Department of Breast Surgery, Southwest Hospital, Army Medical University from January 2009 to December 2012. Among them, 114 patients received neoadjuvant chemotherapy and 100 patients received adjuvant chemotherapy. The patients were followed up for median 78.0 months (52.0-89.0 months). Survival analysis was performed using Kaplan-Meier method. The survival rates were compared by Log-rank test. Results The DFS was 65.8 months (range: 40.6 to 91.9 months) in adjuvant chemotherapy group, 62.1 months (range: 35.2 to 89.1 months) in neoadjuvant chemotherapy group, indicating no significant difference (χ2=0.507, P=0.476). The OS was 70.5 months (45.1 to 96.0 months) in adjuvant chemotherapy group, and 67.3 months (43.9 to 91.1 months) in neoadjuvant chemotherapy group, indicating no significant difference (χ2=1.587, P=0.208). Among 114 patients receiving neoadjuvant chemotherapy, 21 patients (18.4%) achieved pCR and 93 (81.6%) did not achieve pCR. There were significant differences in patient’s age, N stage, surgical method, T stage and clinical stage between pCR group and non-pCR group (χ2=0.137, 0.137, 0.037, Z=0.528, 0.468, all P>0.050). The DFS in pCR group was 69.4 months (50.4-88.3 months), significantly higher than 54.7 months (21.6-87.8 months) in non-pCR group (χ2=3.915, P=0.048). The OS in pCR group was 69.4 months (53.1-95.7 months), significantly higher than 63.8 months (37.7-89.9 months) in non-pCR group (χ2=4.632, P=0.031). Conclusions In triple negative breast cancer, the prognosis of patients receiving neoadjuvant chemotherapy may be similar to that of patients receiving adjuvant chemotherapy. The prognosis of patients achieving pCR after neoadjuvant chemotherapy is better than that of patients without pCR. Key words: Breast neoplasms; Chemotherapy, adjuvant; Prognosis