Skip to main content

Advertisement

SpringerLink
Log in

Effect of Neoadjuvant Chemotherapy on Hormone and Her2neu Receptor Expression in Breast Cancer Patients—a Prospective Cohort Study

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Breast cancer accounts for 27% of all cancers in women in India. Treatment of these patients is influenced by expression of tumor biomarkers. There have been recent reports that neoadjuvant chemotherapy (NAC) results in alteration in the expression of hormone receptors (HR) and Her2neu receptors in breast cancer. The aim of this prospective cohort study was to study the effect of neoadjuvant chemotherapy on expression of hormone and Her2neu receptors in breast cancer patients. Forty patients with biopsy proven breast carcinoma planned for neoadjuvant chemotherapy were included in the study. Their receptor status before and after NAC were recorded and studied. The mean age of our 40 patients was 48.3 years. 72.5% of the patients were in stage 3, 27.5% in stage 2, and none in stage 1 and IV. Patients (12.5%) had change in estrogen receptor (ER) after NAC, of which in 2.5% the ER changed from negative to positive. Patients (17.5%) had change in progesterone receptor (PR) after NAC, of which in 5% the PR changed from negative to positive. Twenty percent of patients had change in Her2neu after NAC, of which in 10% Her2neu changed from negative to positive. Total changes in receptor status were seen in 20 receptors, in 17 out of 40 patients. We recommend revaluation of HR and Her2neu receptors after NAC as a significant number of patients switch from negative to positive receptor status after NAC, and these patients might benefit from the additional therapies which would otherwise have been withheld from them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig 1
Fig. 2

Similar content being viewed by others

Availability of Data and Material

Yes.

Code availability

Not applicable.

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65(2):87–108. https://doi.org/10.3322/caac.21262

    Article  PubMed  Google Scholar 

  2. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ, Panel members (2011) Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22(8):1736–1747. https://doi.org/10.1093/annonc/mdr304

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Pesich R, Geisler S, Demeter J, Perou CM, Lønning PE, Brown PO, Børresen-Dale AL, Botstein D (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A 100(14):8418–8423. https://doi.org/10.1073/pnas.0932692100

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752. https://doi.org/10.1038/35021093

    Article  CAS  PubMed  Google Scholar 

  5. Yang XR, Sherman ME, Rimm DL, Lissowska J, Brinton LA, Peplonska B et al (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomark Prev 16(3):439–443. https://doi.org/10.1158/1055-9965.EPI-06-0806

    Article  CAS  Google Scholar 

  6. Colleoni M, Goldhirsch A (2014) Neoadjuvant chemotherapy for breast cancer: any progress? Lancet Oncol 15(2):131–132. https://doi.org/10.1016/S1470-2045(13)70584-9

    Article  PubMed  Google Scholar 

  7. Thompson AM, Moulder-Thompson SL (2012) Neoadjuvant treatment of breast cancer. Ann Oncol 23 Suppl 10(Suppl 10):x231–x236. https://doi.org/10.1093/annonc/mds324

    Article  CAS  PubMed  Google Scholar 

  8. Read RL, Flitcroft K, Snook KL, Boyle FM, Spillane AJ (2015) Utility of neoadjuvant chemotherapy in the treatment of operable breast cancer. ANZ J Surg 85(5):315–320. https://doi.org/10.1111/ans.12975

    Article  PubMed  Google Scholar 

  9. Nishino M, Jagannathan JP, Ramaiya NH, Van den Abbeele AD (2010) Revised RECIST guideline version 1.1: what oncologists want to know and what radiologists need to know. AJR Am J Roentgenol 195(2):281–289. https://doi.org/10.2214/AJR.09.4110

    Article  PubMed  Google Scholar 

  10. Mieog JS, van der Hage JA, van de Velde CJ (2007) Preoperative chemotherapy for women with operable breast cancer. Cochrane Database Syst Rev 2007(2):CD005002. https://doi.org/10.1002/14651858.CD005002.pub2

    Article  PubMed Central  Google Scholar 

  11. Zhang N, Moran MS, Huo Q, Haffty BG, Yang Q (2011) The hormonal receptor status in breast cancer can be altered by neoadjuvant chemotherapy: a meta-analysis. Cancer Investig 29(9):594–598. https://doi.org/10.3109/07357907.2011.621913

    Article  CAS  Google Scholar 

  12. van de Ven S, Smit VTHBM, Dekker TJA, Nortier JWR, Kroep JR (2011) Discordances in ER, PR and HER2 receptors after neoadjuvant chemotherapy in breast cancer. Cancer Treat Rev 37(6):422–430. https://doi.org/10.1016/j.ctrv.2010.11.006

    Article  CAS  PubMed  Google Scholar 

  13. Qin Q, Gao F, Jiang W, Tan Q, Mo Q, Wei C (2014) Effect of neoadjuvant chemotherapy on expressions of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 in breast cancer. Chin Med J 127(18):3272–3277

    Article  PubMed  Google Scholar 

  14. Yang YF, Liao YY, Li LQ, Xie SR, Xie YF, Peng NF (2013) Changes in ER, PR and HER2 receptors status after neoadjuvant chemotherapy in breast cancer. Pathol Res Pract 209(12):797–802. https://doi.org/10.1016/j.prp.2013.08.012

    Article  CAS  PubMed  Google Scholar 

  15. Thomas S, Desai G, Pathania OP, Jain M, Aggarwal L, Ali S et al (2016) Clinico-epidemiological profile of breast cancer patients and the retrospective application of Gail model 2: an Indian perspective. Breast Dis 36(1):15–22. https://doi.org/10.3233/BD-150203

    Article  PubMed  Google Scholar 

  16. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PSY (2007) Spectrum of breast cancer in Asian women. World J Surg 31(5):1031–1040. https://doi.org/10.1007/s00268-005-0585-9

    Article  PubMed  Google Scholar 

  17. Ramteke P, Seenu V, Prashad R, Gupta SD, Iyer V, Deo SVS, Gogia A, Mathur S (2016) Alteration in steroid hormone and Her-2/neu receptor status following neoadjuvant chemotherapy in locally advanced breast cancer: Experience at a tertiary care centre in India. Indian J Cancer 53(3):366–371. https://doi.org/10.4103/0019-509X.200669

    Article  CAS  PubMed  Google Scholar 

  18. Raina V, Bhutani M, Bedi R, Sharma A, Deo SV, Shukla NK, Mohanti BK, Rath GK (2005) Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer 42(1):40–45. https://doi.org/10.4103/0019-509x.15099

    Article  PubMed  Google Scholar 

  19. Shet T, Agrawal A, Chinoy R, Havaldar R, Parmar V, Badwe R (2007) Changes in the tumor grade and biological markers in locally advanced breast cancer after chemotherapy--implications for a pathologist. Breast J 13(5):457–464. https://doi.org/10.1111/j.1524-4741.2007.00465.x

    Article  PubMed  Google Scholar 

  20. Kasami M, Uematsu T, Honda M, Yabuzaki T, Sanuki J, Uchida Y, Sugimura H (2008) Comparison of estrogen receptor, progesterone receptor and Her-2 status in breast cancer pre- and post-neoadjuvant chemotherapy. Breast. 17(5):523–527. https://doi.org/10.1016/j.breast.2008.04.002

    Article  PubMed  Google Scholar 

  21. Neubauer H, Gall C, Vogel U, Hornung R, Wallwiener D, Solomayer E, Fehm T (2008) Changes in tumour biological markers during primary systemic chemotherapy (PST). Anticancer Res 28(3B):1797–1804

    PubMed  Google Scholar 

  22. Adams AL, Eltoum I, Krontiras H, Wang W, Chhieng DC (2008) The effect of neoadjuvant chemotherapy on histologic grade, hormone receptor status, and HER2/neu status in breast carcinoma. Breast J 14(2):141–146. https://doi.org/10.1111/j.1524-4741.2007.00544.x

    Article  PubMed  Google Scholar 

  23. Rose DP, Davis TE (1980) Effects of adjuvant chemohormonal therapy on the ovarian and adrenal function of breast cancer patients. Cancer Res 40:4043–4047

    CAS  PubMed  Google Scholar 

  24. Colleoni M, Viale G, Zahrieh D, Pruneri G, Gentilini O, Veronesi P, Gelber RD, Curigliano G, Torrisi R, Luini A, Intra M, Galimberti V, Renne G, Nolè F, Peruzzotti G, Goldhirsch A (2004) Chemotherapy is more effective in patients with breast cancer not expressing steroid hormone receptors: a study of preoperative treatment. Clin Cancer Res 10(19):6622–6628. https://doi.org/10.1158/1078-0432.CCR-04-0380

    Article  CAS  PubMed  Google Scholar 

  25. Penault-Llorca F, Cayre A, Mishellany FB, Amat S, Feillel V, Le Bouedec G et al (2003) Induction chemotherapy for breast carcinoma: predictive markers and relation with outcome. Int J Oncol 22(6):1319–1325

    CAS  PubMed  Google Scholar 

  26. Hirata T, Shimizu C, Yonemori K, Hirakawa A, Kouno T, Tamura K, Ando M, Katsumata N, Fujiwara Y (2009) Change in the hormone receptor status following administration of neoadjuvant chemotherapy and its impact on the long-term outcome in patients with primary breast cancer. Br J Cancer 101(9):1529–1536. https://doi.org/10.1038/sj.bjc.6605360

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Surgery and Pathology, Lady Hardinge Medical College, New Delhi, 110001, India

    Janitta Kundaikar, Shaji Thomas, Kiran Aggarwal, O. P. Pathania & Manoj Andley

Authors
  1. Janitta Kundaikar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaji Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kiran Aggarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. O. P. Pathania
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manoj Andley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shaji Thomas.

Ethics declarations

Ethics Approval

Yes.

Consent for Publication

Yes.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kundaikar, J., Thomas, S., Aggarwal, K. et al. Effect of Neoadjuvant Chemotherapy on Hormone and Her2neu Receptor Expression in Breast Cancer Patients—a Prospective Cohort Study. Indian J Surg 83 (Suppl 2), 504–510 (2021). https://doi.org/10.1007/s12262-021-02901-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-021-02901-3

Keywords

Search

Navigation