, Volume 34, Issue 8, pp 1984-1985
Date: 25 Feb 2010

Letter: The Importance of Complete Pathologic Response after Neoadjuvant Systemic Treatment in Breast Cancer Research and Practice

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In a recent issue of the World Journal of Surgery, Al Mushawah et al. [1] report the results of a study of neoadjuvant treatment in breast cancer. Based on image-guided fine needle aspiration biopsy, which showed node-positive disease in 90 patients, the authors assessed the pathological complete response (pCR) after neoadjuvant treatment and subsequent axillary lymph node dissection (ALND). The pCR rate in these node-positive patients was 25% among those who received neoadjuvant chemotherapy, whereas no patient had a pCR in a nodal specimen after neoadjuvant endocrine therapy.

We may ask why the results of this study are interesting. Pathological complete response after neoadjuvant (preoperative) systemic treatment is considered a surrogate predictor of good outcome in breast cancer. Indeed, the eradication of all cancer cells at the primary site of cancer in the breast and axillary lymph nodes indicates a very high responsiveness to this specific systemic treatment. Indirectly, this p ...