TY - JOUR
T1 - Predictors of recurrence in breast cancer patients with a pathologic complete response after neoadjuvant chemotherapy
AU - Tanioka, M.
AU - Shimizu, C.
AU - Yonemori, K.
AU - Yoshimura, K.
AU - Tamura, K.
AU - Kouno, T.
AU - Ando, M.
AU - Katsumata, N.
AU - Tsuda, H.
AU - Kinoshita, T.
AU - Fujiwara, Y.
N1 - Funding Information:
This study was supported by a grant for ‘Validation study of pathological response criteria for neoadjuvant chemotherapy for primary breast cancer’ from the Japanese Breast Cancer Society (2008).
PY - 2010/7/27
Y1 - 2010/7/27
N2 - Background:Although a pathologic complete response (pCR) after neoadjuvant chemotherapy is associated with favourable outcomes, a small proportion of patients with pCR have recurrence. This study was designed to identify factors predictive of recurrence in patients with pCR.Methods:A total of 449 breast cancer patients received neoadjuvant chemotherapy, and 88 evaluable patients had a pCR, defined as no evidence of invasive carcinoma in the breast at surgery. The clinical stage was II in 61 patients (69%), III in 27 (31%). All patients received taxanes and 92% received anthracyclines. Among 43 patients with HER2-positive tumours, 27 received trastuzumab. Cox regression analyses were performed to identify predictors of recurrence.Results:Median follow-up was 46.0 months. There were 12 recurrences, including 8 distant metastases. The rate of locoregional recurrence was 10.4% after breast-conserving surgery, as compared with 2.5% after mastectomy. Multivariate analysis revealed that axillary metastases (hazard ratio (HR), 13.6; P0.0001) and HER2-positive disease (HR, 5.0; P<0.019) were significant predictors of recurrence. Five of six patients with both factors had recurrence. Inclusion of trastuzumab was not an independent predictor among patients with HER2-positive breast cancer.Conclusion:Our study results suggest that HER2 status and axillary metastases are independent predictors of recurrence in patients with pCR.
AB - Background:Although a pathologic complete response (pCR) after neoadjuvant chemotherapy is associated with favourable outcomes, a small proportion of patients with pCR have recurrence. This study was designed to identify factors predictive of recurrence in patients with pCR.Methods:A total of 449 breast cancer patients received neoadjuvant chemotherapy, and 88 evaluable patients had a pCR, defined as no evidence of invasive carcinoma in the breast at surgery. The clinical stage was II in 61 patients (69%), III in 27 (31%). All patients received taxanes and 92% received anthracyclines. Among 43 patients with HER2-positive tumours, 27 received trastuzumab. Cox regression analyses were performed to identify predictors of recurrence.Results:Median follow-up was 46.0 months. There were 12 recurrences, including 8 distant metastases. The rate of locoregional recurrence was 10.4% after breast-conserving surgery, as compared with 2.5% after mastectomy. Multivariate analysis revealed that axillary metastases (hazard ratio (HR), 13.6; P0.0001) and HER2-positive disease (HR, 5.0; P<0.019) were significant predictors of recurrence. Five of six patients with both factors had recurrence. Inclusion of trastuzumab was not an independent predictor among patients with HER2-positive breast cancer.Conclusion:Our study results suggest that HER2 status and axillary metastases are independent predictors of recurrence in patients with pCR.
KW - breast cancer
KW - neoadjuvant chemotherapy
KW - pathologic complete response
KW - predictive factor
KW - trastuzumab
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U2 - 10.1038/sj.bjc.6605769
DO - 10.1038/sj.bjc.6605769
M3 - Article
C2 - 20606681
AN - SCOPUS:77955050783
SN - 0007-0920
VL - 103
SP - 297
EP - 302
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 3
ER -
