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Pathological Factors Predicting Neoadjuvant Chemotherapy Response and Survival in Breast Cancer

Abstract

Ak N, Velidedeoglu M, Ucar E, Turna H and Demirelli F

Purpose: In the case of developing resistance to systemic neoadjuvant chemotherapy, patients might tend to present with more advanced diseases later on and become inoperable at the end of their course. We have tried to determine the predictive factors for complete pathological response.

Materials and Methods: Records of 115 patients were reviewed retrospectively. We have collected data related to patient’s sociodemographic features, disease free survival and overall survival, as well as the clinical, histological, molecular and pathological features of their tumor. We have used SPSS statistic program (SPSS 20.0, SPSS Inc. Chicago, Illinois) to analyze statistical inputs.

Findings: 26 patients (22.6%) showed pathological Miller Payne Grade 5 response (T0) and 3 patients showed no measurable tumor, residue with separate tumor cells (T1mi). Presence of HER2-neu expression (p: 0.03), absence of ER and PR expression (p=0.001) and high histological grade (p: 0.025) were found to be associated with complete pathological response. Tumor diameter and lymphoid infiltration were not correlated with complete response. Also, we found that, patients who showed lower pathological nodal stage according to AJCC 8th system, have statistically significant longer survival times (p<0.05 for all), but Miller-Payne Grade 5 response were not predict survival results (p: 0.814 for OS) (p=0.295 for PFS).

Conclusion: Neoadjuvant treatment would be more effective in these types of tumors. Survival effect can be better predicted with pathologic nodal results according to AJCC 8th system. There is a need for randomized prospective studies so that the treatment response can be assessed more appropriately.