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Comparison of Pathologic Response Evaluation Systems after Anthracycline with/without Taxane-Based Neoadjuvant Chemotherapy among Different Subtypes of Breast Cancers
Authors:Hee Jin Lee  In Ah Park  In Hye Song  Sung-Bae Kim  Kyung Hae Jung  Jin-Hee Ahn  Sei-Hyun Ahn  Hak Hee Kim  Gyungyub Gong
Institution:1. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.; 2. Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.; 3. Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.; 4. Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.; University of North Carolina School of Medicine, UNITED STATES,
Abstract:

Purpose

Several methods are used to assess the pathologic response of breast cancer after neoadjuvant chemotherapy (NAC) to predict clinical outcome. However, the clinical utility of these systems for each molecular subtype of breast cancer is unclear. Therefore, we applied six pathologic response assessment systems to specific subtypes of breast cancer and compared the results.

Patients and Methods

Five hundred and eighty eight breast cancer patients treated with anthracycline with/without taxane-based NAC were retrospectively analyzed, and the ypTNM stage, residual cancer burden (RCB), residual disease in breast and nodes (RDBN), tumor response ratio, Sataloff’s classification, and Miller—Payne grading system were evaluated. The results obtained for each assessment system were analyzed in terms of patient survival.

Results

In triple-negative tumors, all systems were significantly associated with disease-free survival and Kaplan-Meier survival curves for disease-free survival were clearly separated by all assessment methods. For HR+/HER2- tumors, systems assessing the residual tumor (ypTNM stage, RCB, and RDBN) had prognostic significance. However, for HER2+ tumors, the association between patient survival and the pathologic response assessment results varied according to the system used, and none resulted in distinct Kaplan—Meier curves.

Conclusion

Most of the currently available pathologic assessment systems used after anthracycline with/without taxane-based NAC effectively classified triple-negative breast cancers into groups showing different prognoses. The pathologic assessment systems evaluating residual tumors only also had prognostic significance in HR+/HER2- tumors. However, new assessment methods are required to effectively evaluate the pathologic response of HR+/HER2+ and HR-/HER2+ tumors to anthracycline with/without taxane-based NAC.
Keywords:
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