ORIGINAL RESEARCH ARTICLE
Benefits of Neoadjuvant Chemotherapy for Luminal Breast Cancer with Respect to Tumor Response
Received Date : 01 May 2020
Accepted Date : 17 Sep 2020
Available Online : 03 Feb 2021
Bala Başak ÖVENa, Serkan ÇELİKa, Günay GÜRLEYİKb, Fügen AKER VARDARc,
Ezgi YÜZÜGÜLLÜ ÇOBANd, Mesut ŞEKERd, İlker Nihat ÖKTENe, Ali AKTEKINf
aDepartment of Medical Oncology, Bahçeşehir University Medical Faculty, İstanbul, TURKEY
bDepartment of General Surgery, Haydarpasa Numune Educartion and Research Hospital, İstanbul, TURKEY
cDepartment of Pathology, Haydarpasa Numune Educartion and Research Hospital, İstanbul, TURKEY
dDepartment of Medical Oncology, Bezmi Alem University, Medical Faculty, İstabul,TURKEY
eDepartment of General Surgey Gaziantep University, Medical Faculty, Gaziantep, TURKEY
Doi: 10.37047/jos.2020-75852 - Article's Language: EN
J Oncol Sci. 2021;7(1):7-14
ABSTRACT
Objective: The pathological complete response (PCR) rate following neoadjuvant chemotherapy (NAC) is prognostic for overall
survival (OS). We evaluated the pathological responses to NAC and related factors in luminal type HER2-positive breast cancer. Materials
and Methods: Hormone receptor (H), HER2/neu status, and Ki67 index were evaluated on 258 core biopsies of breast cancer before
NAC. In total, 194 cancer core biopsies were found to be luminal A or B. A Ki67 index of above 20% together with hormone receptor positivity
and HER2 negativity further confirmed the breast cancer type as luminal B. The relation between pathological responses and the data
obtained were evaluated using the Chi-square test. The OS and disease-free survival (DFS) and related factors were analyzed with univariate
analysis. Results: PCR was achieved in 47 (18.2%) patients, and the objective response was 70.2% after NAC. The 5-year DFS rate was
59.2% that related to surgery type; T, N, and postoperative stages; lymphovascular invasion (LVI); perineural invasion (PNI); and pathological
response to NAC (p < 0.001). The median OS could not be reached, and the 5-year OS rate was 88.5%. Furthermore, the N and postoperative
stages, recurrence, and pathological response to NAC were related to OS. The hormone receptor positivity was related to pathological
response (p = 0.03). Although partial and complete responses were high among hormone receptor-negative tumors, the stable response was
more common among hormone receptor-positive ones. Conclusions: It should be better to recommend NAC to hormone receptor-negative
or HER2-positive tumors unless surgery could not be performed because of the locally advanced tumor due to lower rate of PCR or partial
response with NAC in hormone receptor-positive tumors.
Keywords: Breast cancer; neoadjuvant chemotherapy; luminal type