Predictive factors of pathological complete response in a Portuguese population with breast cancer treated with neoadjuvant chemotherapy

• Main Author: Neves,Ana Raquel
• Publication Date: 2019
• Other Authors: Pires,Rafaela, Caramelo,Olga, Henriques,Isabel, Belo,Joana
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302019000400002
• topic: Breast cancer; Neoadjuvant therapy; Pathology; Immunohistochemistry

Overview and Aims: Neoadjuvant chemotherapy is increasingly being used in the treatment of operable breast cancer. Our aim was to evaluate the factors that predict pathological complete response (pCR) after neoadjuvant chemotherapy in a Portuguese population of breast cancer patients. Study design: Retrospective, cross-sectional study. Population: Women diagnosed with breast cancer stage I-III treated with neoadjuvant chemotherapy and subsequent surgery in our institution during a 6-year period. Methods: Clinical records were reviewed. Patient demographics and tumour characteristics were evaluated. Univariate and multivariate analysis were performed to evaluate tumour’s clinical and immunohistochemical characteristics associated with pCR. Results: A total of 164 patients enrolled the sudy. The overall rate of pCR was 17.7%. The rate was significantly higher in HER2-positive (non-luminal) tumours (66.7%) and lower in luminal A tumours (0%). The nuclear grade, estrogen receptor (ER), progesterone receptor (PR), HER2 status and Ki67 proliferation index significantly influenced the rate of pCR. However, multivariate analysis revealed that only negative ER and positive HER2 are significant predictors of pCR [respectively, ORadj 0.187 (95% CI 0.038-0.908; p=0.038) and ORadj 4.186 (95% CI 1.401-12.508; p=0.010)]. Conclusion: ER status and HER2 status are the most important predictors of pathological complete response. These findings should be considered in patient counselling, providing a more customized therapeutic approach.