Predictors of recurrence in breast cancer patients with a pathologic complete response after neoadjuvant chemotherapy

M. Tanioka, C. Shimizu, K. Yonemori, K. Yoshimura, K. Tamura, T. Kouno, M. Ando, N. Katsumata, H. Tsuda, T. Kinoshita, Y. Fujiwara

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40 Citations (Scopus)

Abstract

Background:Although a pathologic complete response (pCR) after neoadjuvant chemotherapy is associated with favourable outcomes, a small proportion of patients with pCR have recurrence. This study was designed to identify factors predictive of recurrence in patients with pCR.Methods:A total of 449 breast cancer patients received neoadjuvant chemotherapy, and 88 evaluable patients had a pCR, defined as no evidence of invasive carcinoma in the breast at surgery. The clinical stage was II in 61 patients (69%), III in 27 (31%). All patients received taxanes and 92% received anthracyclines. Among 43 patients with HER2-positive tumours, 27 received trastuzumab. Cox regression analyses were performed to identify predictors of recurrence.Results:Median follow-up was 46.0 months. There were 12 recurrences, including 8 distant metastases. The rate of locoregional recurrence was 10.4% after breast-conserving surgery, as compared with 2.5% after mastectomy. Multivariate analysis revealed that axillary metastases (hazard ratio (HR), 13.6; P0.0001) and HER2-positive disease (HR, 5.0; P<0.019) were significant predictors of recurrence. Five of six patients with both factors had recurrence. Inclusion of trastuzumab was not an independent predictor among patients with HER2-positive breast cancer.Conclusion:Our study results suggest that HER2 status and axillary metastases are independent predictors of recurrence in patients with pCR.

Original languageEnglish
Pages (from-to)297-302
Number of pages6
JournalBritish Journal of Cancer
Volume103
Issue number3
DOIs
Publication statusPublished - Jul 27 2010
Externally publishedYes

Keywords

  • breast cancer
  • neoadjuvant chemotherapy
  • pathologic complete response
  • predictive factor
  • trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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