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. 2024 Mar 23;40(1):73-81.
doi: 10.47717/turkjsurg.2024.6308. eCollection 2024 Mar.

Pathological complete response and associated factors in breast cancer after neoadjuvant chemotherapy: A retrospective study

Adnan Gündoğdu  1 , Mehmet Uluşahin  1 , Arif Burak Çekiç  1 , Seher Nazlı Kazaz  2   3 , Ali Güner  1   4
Affiliations

Pathological complete response and associated factors in breast cancer after neoadjuvant chemotherapy: A retrospective study

Adnan Gündoğdu et al. Turk J Surg. .

Abstract

Objectives: This study aimed to determine clinical and pathological factors that identify a pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NAC).

Material and methods: A retrospective, single-center study was conducted in women over the age of 18 who had been diagnosed with pathologically confirmed invasive breast cancer and who had received NAC between July 2016 and October 2021. Patient demographics, clinical, radiological, treatment, and pathological data were reviewed from the electronic hospital records. The primary outcome of interest was pCR, defined as the absence of residual invasive breast cancer in both the breast and axillary lymph nodes. Multivariable logistic regression analysis was used to identify factors associated with pCR.

Results: A total of 119 patients were included in the analysis. The distribution of age was 54.5 ± 11.5 years. pCR was observed in 33 (27.7%) patients. pCR for breast tissue was observed in 43 (36.1%) patients. There was no statistically significant relation between the clinical stage and pCR. Age, age at first labor, extent of disease in the breast, NAC completeness, clinical tumor size (cT) stage, clinical lymph node (cN) stage, and molecular subtype were analyzed in a multivariable model. Analysis showed that molecular subtype was the only independent factor related to pCR. pCR rates across molecular subtypes were: 8.7% in luminal-A, 10.8% in luminal-B, 54.5% in human epidermal growth factor receptor 2 (HER-2)-positive, 42.4% in luminal-B (HER-2 positive) and 46.7% in triple-negative. There was no statistically significant difference between luminal-A and luminal-B subgroups (odds ratio 1.15, 95% confidence interval, 0.19-9.35, p= 0.881). Despite the limited number of patients in HER2-positive and triple-negative groups, both demonstrated statistically significant higher odds compared to reference group.

Conclusion: The presented study underscores the relevance of molecular subtypes in determining the response to neoadjuvant chemotherapy in breast cancer patients. Particularly HER2-positive and triple-negative subtypes may demonstrate more favorable response rates.

Keywords: Breast cancer; molecular subtypes; neoadjuvant chemotherapy; pathological complete response.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. pCR and non-pCR rates for the breast, axilla and overall.
Figure 2
Figure 2. pCR rates according to molecular subtypes.
See this image and copyright information in PMC

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