Morphological and pathological response in primary systemic therapy of patients with breast cancer and the prediction of disease free survival: a single center observational studyReportar como inadecuado




Morphological and pathological response in primary systemic therapy of patients with breast cancer and the prediction of disease free survival: a single center observational study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Croatian medical journal, Vol.57 No.2 April 2016. -

Aim To identify breast cancer subtypes likely to respond

to primary systemic therapy PST or neoadjuvant therapy

and to assess the accuracy of physical examination PE and

breast ultrasonography US in evaluating and predicting residual

size of breast carcinoma following PST.

Methods 116 patients who received at least two cycles of

PST between 1998 and 2009 were selected from a prospectively

collected clinical database. Radiological assessment

was done by mammography and US. Prior to PST, tumors

were subclassified according to core biopsy NCB and-or

fine-needle aspiration-based immunohistochemical profiles

of NCB. Pathological response rates were assessed following

the surgeries by using Chevallier classification. Tumor measurements

by PE and US were obtained before and after PST.

Different clinical measurements were compared with histological

findings. Disease-free survival DFS was assessed.

Results Pathological complete remission pCR = Chevallier

I-II was observed in 25 patients 21.5%, 44% of whom

had triple negative histology, 28% Her2 positive and 76%

had high-grade tumor. Of 116 patients, 24 received taxanebased

PST, 48 combined taxane + anthracycline treatment,

8 trastuzumab combinations, 21 anthracycline-based treatments,

and 15 other treatments. In the taxane treated group,

the pCR rate was 30%, in the taxane + anthracycline group

25%, in the anthracycline group 9.5%, and in trastuzumab

group 37.5%. After PST, PE and US were both significantly

associated with pathology P < 0.001 and P = 0.004, respectively.

Concerning OS, significant difference was observed

between the Chevallier III and IV group P = 0.031 in favor

of Chevallier III group. In the pCR group, fewer events were

observed during the follow-up period.

Conclusions Our results show that even limited, routinely

used immunohistochemical profiling of tumors can predict

the likelihood of pCR to PST: patients with triple negative

and Her2-positive cancers are more likely to achieve pCR to

PST. Also, PE is better correlated with pathological findings

than US.



Autor: Gyöngyvér Szentmártoni - ; Semmelweis University, Department of Clinical Oncology, Budapest, Hungary Anna-Mária Tőkés - ; 2

Fuente: http://hrcak.srce.hr/



DESCARGAR PDF




Documentos relacionados