More precise mitotic count and estrogen/progesteron (ER/PR) scoring system impact on grading in pre- and post-neoadjuvant primary breast cancer: morphological, clinical and radiological assessment
Background: Breast cancer molecular subtypes (Luminal A and B, Triple negative, Her2-enriched) together with histology-based parameters (i.e. grading) are pivotal in understanding how tumor response is related to relapse risk and would help clinicians make decisions about additional treatment options after neoadjuvant chemotherapy (NCT). Different methods can be used to assess ER/PR status (Allred score, H score, semiquantitative score). Mitotic index (MI) can be performed on conventional histology or by using immunohistochemistry for phosphohistone H3 (PHH3).
AbstractIntroductionPrediction models are useful to guide decision making. Our goal was to compare three published nomograms predicting axillary response to neoadjuvant chemotherapy (NAC), clinically node-positive breast cancer.MethodsPatients with cT1 –T4, cN1–N3 breast cancer treated with NAC and surgery from 2008 to 2019 were reviewed. The predicted probability of pathologic node-negative (ypN0) status was estimated for each nomogram. Area under the curve (AUC) was compared across models, overall and by biologic subtype.ResultsOf 581 patients, 253 (43.5%) were ypN0. ypN0 status varied by subtype: 23.9% for e...
We reported nodal and breast downstaging rates with NET, and compared axillary response rates following NET and neoadjuvant chemotherapy (NAC).MethodsConsecutive stage I –III breast cancer patients treated with NET and surgery from January 2009 to December 2019 were identified from a prospectively maintained database. Nodal pCR rates were compared between biopsy-proven node-positive patients treated with NET, and HR+/HER2- patients treated with NAC from November 2 013 to July 2019.Results127 cancers treated with NET and 338 with NAC were included. NET recipients were older, more likely to have lobular and lower-grade...
CONCLUSION: The probability of nodal positivity after neoadjuvant chemotherapy was less than 3 per cent in patients with TNBC or HER2-positive disease who achieved a breast rCR on MRI. These patients could be included in trials investigating the omission of sentinel node biopsy after neoadjuvant chemotherapy. PMID: 33031572 [PubMed - as supplied by publisher]
Conditions: HER2-negative Breast Cancer; Neoadjuvant Chemotherapy Interventions: Drug: Epirubicin; Drug: Cyclophosphamid; Drug: Docetaxel; Drug: Paclitaxel Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University Recruiting
ConclusionsThis retrospective study demonstrated that age at diagnosis was independently associated with IBTR-free survival. Special caution is needed when clinical trials analyzing omission of breast surgery after NAC are enrolling younger patients (UMIN-CTR No. UMIN000037067).
Background: PIK3CA mutations are known to be associated with a reduced pathological complete response (pCR) rate in HER2+ breast cancer, but the relationship between PIK3CA mutations and the therapeutic effects of neoadjuvant chemotherapy in hormone receptor (HR) -positive or HR −/HER2− breast cancer is not clear. We herein analyzed PIK3CA mutations in primary breast cancers of patients who had undergone neoadjuvant chemotherapy. We also investigated the associations of these mutations with the therapeutic effects of neoadjuvant chemotherapy.
Background: Pertuzumab combined with trastuzumab and chemotherapy is now the standard neoadjuvant treatment for non-metastatic HER2-positive early breast cancer (HER2+ BC). However, information on the efficacy of this combination in Asian population is sparse. This retrospective study aims to assess the clinical outcome of adding pertuzumab to trastuzumab and chemotherapy (PH/CTX) for stage II to III HER2+ BC in an Asian cohort.
Background: The tumor-stroma ratio (TSR) has proven to be a strong prognostic factor in breast cancer, demonstrating better survival for patients with stroma-low tumors. Since the role of TSR as a predictive marker for neoadjuvant chemotherapy outcome is yet unknown, this association was evaluated for HER2-negative breast cancer in the prospective DIRECT and NEOZOTAC trials.
CONCLUSION: This study showed that in HER2-positive operable or locally advanced breast cancer, the tpCR rate of P + EC-TH neoadjuvant therapy was about twice as high as that of EC-TH neoadjuvant therapy reported in other trials, with tolerable side effects. PMID: 33000490 [PubMed - as supplied by publisher]