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Clinical Usefulness of AJCC Response Criteria for Neoadjuvant Chemotherapy in Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Recently, the American Joint Committee on Cancer (AJCC) 7th edition proposed new response criteria for neoadjuvant chemotherapy (NAC) in breast cancer. The purpose of this study was to evaluate the clinical usefulness of AJCC response criteria.

Methods

A total of 398 consecutive stage II or III breast cancer patients who received NAC were enrolled in this study. AJCC response criteria were as follows: (1) complete response (CR)—absence of invasive carcinoma in the breast and node; (2) partial response (PR)—decrease in either or both T or N stage; (3) no response (NR)—no change or increase in either or both T or N stage.

Results

Complete response, PR, and NR by AJCC criteria were 9.8, 59.3, and 30.7 %, respectively. Among the 398 patients, 337 patients were available for both paired pre- and post- breast MRI and chest CT. AJCC response criteria were significantly associated with RECIST criteria (P < 0.001). AJCC response was significantly associated with relapse-free survival (RFS) and overall survival (OS). The 5-year RFS rates were 89.6 % in CR, 74.1 % in PR, and 62.6 % in NR (P = 0.002). The 5-year OS rates were 97.4 % in CR, 88.6 % in PR, and 78.3 % in NR (P = 0.012). When adjusting potential prognostic factors, AJCC response was independently associated with RFS and OS.

Conclusions

AJCC response criteria for NAC in breast cancer have clinical usefulness in evaluating response of NAC, as well as predicting survival. AJCC response criteria can discriminate among patient subgroups with respect to survival.

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Acknowledgment

This study was supported by Basic Science Research Program (2010-0022299) and Priority Research Centers Program (2009-0093820) through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology and partly supported by grant no. 03-2010-019 from the Seoul National University Hospital Research Fund.

Conflict of interest

The authors declare that no conflict of interest exists.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

    Bhumsuk Keam MD, Seock-Ah Im MD, PhD, Yoojoo Lim MD, Sae-Won Han MD, PhD, Do-Youn Oh MD, PhD, Se-Hoon Lee MD, PhD, Dong-Wan Kim MD, PhD & Tae-You Kim MD, PhD

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Bhumsuk Keam MD, Seock-Ah Im MD, PhD, Sae-Won Han MD, PhD, Hyeong-Gon Moon MD, PhD, Do-Youn Oh MD, PhD, Se-Hoon Lee MD, PhD, Wonshik Han MD, PhD, Dong-Wan Kim MD, PhD, Tae-You Kim MD, PhD, In Ae Park MD, PhD & Dong-Young Noh MD, PhD

  3. Department of Surgery, Seoul National University Hospital, Seoul, Korea

    Hyeong-Gon Moon MD, PhD, Wonshik Han MD, PhD & Dong-Young Noh MD, PhD

  4. Department of Radiology, Seoul National University Hospital, Seoul, Korea

    Nariya Cho MD, PhD & Woo Kyung Moon MD, PhD

  5. Department of Pathology, Seoul National University Hospital, Seoul, Korea

    In Ae Park MD, PhD

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  1. Bhumsuk Keam MD
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  2. Seock-Ah Im MD, PhD
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Corresponding author

Correspondence to Seock-Ah Im MD, PhD.

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Keam, B., Im, SA., Lim, Y. et al. Clinical Usefulness of AJCC Response Criteria for Neoadjuvant Chemotherapy in Breast Cancer. Ann Surg Oncol 20, 2242–2249 (2013). https://doi.org/10.1245/s10434-012-2756-x

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  • DOI: https://doi.org/10.1245/s10434-012-2756-x

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