Nodal Response to Neoadjuvant Chemotherapy is a Better Predictive Factor of Survival Than Miller-Payne Scoring in Breast Cancer
Received Date : 28 Sep 2020
Accepted Date : 30 Mar 2021
Available Online : 14 Apr 2021
Doi: 10.37047/jos.2020-79256 - Article's Language: EN
J Oncol Sci. 2021;7(2):42-9
This is an open access article under the CC BY-NC-ND license
Objective: Neoadjuvant chemotherapy (NAC) is a widely used treatment modality for breast cancer and may delay surgery for unresponsive patients. The objective of this study was to determine the predictive factors for complete pathological response and survival after NAC for the most appropriate patient selection before treatment. Material and Methods: Records of breast cancer patients with NAC between 2011 and 2015 were reviewed retrospectively. Statistical analysis was done using SPSS version 20.0 (SPSS Inc., Chicago, Illinois). Results: Twenty-six patients (22.6%) showed pathological Miller Payne Grade 5 response (T0), and three patients showed no measurable tumor, residue with separate tumor cells (T1 mi). The presence of HER2-neu expression (p=0.03), absence of estrogen receptor (ER) and progesterone receptor (PR) expression (p=0.001), and high histological grade (p=0.025) were found associated with complete pathological response. Tumor diameter and lymphoid infiltration showed no correlation with complete pathological response. Also, we found that patients who showed lower pathological nodal stage according to American Joint Committee on Cancer (AJCC), 8th edition had statistically significant longer survival period (p<0.05), but Miller-Payne Grade 5 response could not predict survival results [p=0.814 for overall survival (OS) and p=0.295 for progression-free survival (PFS)]. Conclusion: Neoadjuvant treatment would be more effective in tumors with ER-negative, HER-2 positive, and high-grade properties. Survival effect might be predicted earlier with pathologic nodal results according to AJCC cancer staging system, 8th edition.
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