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Past
The residual cancer burden (RCB) was developed as a standard scoring system to report residual disease burden at surgery after neoadjuvant chemotherapy.1 The utility of this scoring system in the context of different breast cancer phenotypes was not well established.
Present
In our study, we evaluated the RCB after neoadjuvant chemotherapy in different breast cancer phenotypic subtypes to determine if this was predictive of survival outcomes.2 Our results found the RCB to be predictive of overall survival and recurrence in patients with triple-negative and HER2-positive breast cancer. However, the RCB was not predictive in the hormone receptor-positive, HER2-negative patients. We hypothesized that were unable to show a difference in this group due to an overall low event rate of recurrence and death.
Future
Since submission of our paper, a multicenter, polled analysis was recently published that evaluates the RCB in different phenotypic subtypes. This analysis found the RCB to be predictive in all subtypes, including the hormone receptor-positive, HER2-negative group.3 The RCB provides useful information for patients undergoing neoadjuvant therapy and should be incorporated in the adjuvant treatment planning for neoadjuvant chemotherapy patients.
References
Symmans WF, Peintinger F, Hatzis C, et al. Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy. J Clin Oncol. 2007;25(28):4414–22.
Elder EA, Livasy C, Donahue E, et al. Residual cancer burden class associated with survival outcomes in women with different phenotypic subtypes of breast cancer after neoadjuvant chemotherapy. Ann Surg Oncol. 2022. https://doi.org/10.1245/s10434-022-12300-x.
Yau C, Osdoit M, van der Noordaa M, et al. Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre polled analysis of 5161 patients. Lancet. 2022;23:149–60.
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Elder, E.A., White, R. ASO Author Reflections: Residual Cancer Burden Across Phenotypic Subtypes. Ann Surg Oncol 29, 8070 (2022). https://doi.org/10.1245/s10434-022-12334-1
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DOI: https://doi.org/10.1245/s10434-022-12334-1