Is pathological complete response predictable after neoadjuvant chemotherapy in breast cancer? A single institution's retrospective experience

Abstract

Background: Pathological complete response (pCR), in breast cancers, after neoadjuvant chemotherapy is linked to improved survival. Determining complete response to chemotherapy prior to surgery has remained elusive even using a combination of pathological factors and imaging modalities, making surgery still a necessity. Methods: A retrospective analysis was performed from a single institution from 2013 to 2018. Breast cancer patients treated with neoadjuvant chemotherapy with pre-and postchemotherapy magnetic resonance imaging (MRI) were included. Patients receiving other neoadjuvant modalities were excluded. Imaging characteristics, including response to chemotherapy and pathological factors, were recorded. Results: Analysis showed 134 patients were identified with 40/134 (29.9%) noted to have radiological complete response and 34/134 (25.6%) had pCR. The positive predictive value for MRI to detect pCR was greatest for oestrogen receptor (ER) negative and human epidermal growth factor receptor 2 (HER2) negative tumours at 81.8% and worst for ER+ HER2À tumours at 25%. The negative predictive value was greatest for ER+ HER2À tumours at 93.9% and worst for ERÀ HER2À tumours at 77.4%. Conclusion: MRI after neoadjuvant chemotherapy for breast cancer even combined with tumour factors is not an accurate predictor of pCR.

The influence factors of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy

“…Breast cancer is a heterogeneous tumor. Different pathological indicators and clinical features of breast cancer patients often mean different sensitivity of neoadjuvant chemotherapy and survival prognosis [21]. This study found that neoadjuvant chemotherapy e cacy and survival prognosis in breast cancer patients were correlated with TNM staging, breast cancer tissue sex hormone receptor, Ki-67 expression and neoadjuvant chemotherapy, but not related to age, body mass index, neoadjuvant chemotherapy cycle, pCR and the expression of Her-2.…”