Impact of pathological complete response to neoadjuvant chemotherapy in invasive breast cancer according to molecular subtype

• Published in: Gynécologie, obstétrique, fertilité & sénologie obstétrique, fertilité & sénologie, 2017-10, Vol.45 (10), p.535-544
• Main Authors: Cirier, J, Body, G, Jourdan, M-L, Bedouet, L, Fleurier, C, Pilloy, J, Arbion, F, Ouldamer, L
• Format: Article
• Language: eng ; fre
• Subjects: Adult; Aged; Aged, 80 and over; Axilla; Breast Neoplasms - classification; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Chemotherapy, Adjuvant - statistics & numerical data; Female; Humans; Lymph Nodes - pathology; Mastectomy; Middle Aged; Neoadjuvant Therapy - statistics & numerical data; Neoplasm Invasiveness - pathology; Receptor, ErbB-2 - analysis; Receptors, Estrogen - analysis; Receptors, Progesterone - analysis; Treatment Outcome
• ISSN: 2468-7189
• DOI: 10.1016/j.gofs.2017.08.002

The aim of this study was to evaluate the impact of pathological complete response (pCR) on overall survival (OS) and recurrence-free survival (RFS) according to molecular subtypes in women treated for an invasive breast cancer after neoadjuvant chemotherapy (NAC). All women (n=225) managed with a neoadjuvant chemotherapy for an invasive breast cancer in our institution between January 2007 and December 2013 were included. The characteristics of patients with pCR (pCR-1), breast pCR and axillary pCR were compared to those without pCR (pCR-0) according to the molecular subtypes: luminal A (n=62), luminal B (n=77), Her-2 (n=31) and triple negative (n=55). NAC concerned 225 patients of whom 36 (16%) had pCR. Achievement of pCR led to significantly better overall survival in women with Her-2 tumors (35% versus 100%, P=0.035) and also to significantly better locoregional survival in women treated for triple negative tumors (P=0.026). Predictive factors of pCR were a high pathologic grade: OR=2.39, IC 95% (1.19-4.83), P=0.008; Her-2 molecular subtype (P=0.008); positive estrogenic hormonal receptors (P=0.006), a positive Her-2 receptor: OR=2.58, IC 95% (1.20-5.54), P=0.01. Achievement of pCR is an intermediate marker of survival in women managed with NAC for breast cancer.