Nodal Response to Neoadjuvant Chemotherapy is a Better Predictive Factor of Survival Than Miller-Payne Scoring in Breast Cancer

Abstract

Neoadjuvant chemotherapy (NAC) could eliminate existing potential micrometastases and prevent the growth of occult micrometastases that originated from released tumor cells during surgery, and also allowed breast-conserving at higher rates. 1 Though the main expected benefit of treatment modalities is to improve disease-free survival (DFS) and progressionfree survival, investigators are trying to translate therapeutic results into better survival rates. It is critical to avoid under-treatment or overtreatment, despite a lack of clarity in determining the extent of the therapy and aiming for the best survival results.Breast cancer has been staged using the American Joint Committee on Cancer (AJCC) Tumor, Node, and Metastasis (TNM) staging system since the first edition in 1977. 2 There are different neoadjuvant response evaluation systems, and "Miller-Payne Criteria" is accepted useful in various cancer centers; it is graded from 1 to 5; because the pathological examination has decision-making importance and has not been standardized yet. 3 Also, the clinical course of patients with pathologic complete response (pCR) remains unclear due to conflicting results.