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Clinicopathological Features of Tumors as Predictors of the Efficacy of Primary Neoadjuvant Chemotherapy for Operable Breast Cancer

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Abstract

Background

Neoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early-stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reduction to reduce the volume of subsequent breast resection. Clinicopathological markers that predict patient response to NC are needed to individualize treatment.

Methods

From 1998 to 2006, 368 patients with primary breast cancer underwent curative surgical treatment after NC (anthracycline and/or taxane without trastuzumab). We retrospectively evaluated the clinicopathological features and classification of the tumors using computed tomography (CT) before NC and analyzed the correlation with the pathological complete response (pCR) and reduction of tumor size after treatment.

Results

The overall response and pCR rates in these patients were 86% and 17%, respectively. In multivariate analysis, classification as a scirrhous-type tumor was an independent predictor of reduced likelihood of pCR (p = 0.0115; odds ratio 0.21). For tumor reduction, histological grade 3 (p = 0.0002; odds ratio 3.3) and localized tumors identified by using CT imaging (p = 0.0126; odds ratio 2.4) were independent predictors in multivariate analysis.

Conclusions

In this study, NC often did not result in pCR for breast cancers classified as scirrhous. Furthermore, tumor type classification using CT imaging and histological grading was effective to predict tumor reduction in response to NC that included an anthracycline and/or a taxane.

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Authors and Affiliations

  1. Department of Surgery, National Cancer Center Hospital, Tokyo, Japan

    Tadahiko Shien, Sadako Akashi-Tanaka, Takashi Hojo & Takayuki Kinoshita

  2. Department of Cancer and Thoracic Surgery, Okayama University, 1-5-2 Shikata-cho, Okayama-Shi, Okayama, 700-8558, Japan

    Tadahiko Shien, Naruto Taira & Hiroyoshi Doihara

  3. Nagano PET Imaging and Diagnostic Center, Nagano, Japan

    Kunihisa Miyakawa

  4. Breast and Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan

    Chikako Shimizu, Masashi Ando, Tsutomu Kohno, Noriyuki Katsumata & Yasuhiro Fujiwara

  5. Department of Pathology, National Cancer Center Hospital, Tokyo, Japan

    Kunihiko Seki

Authors
  1. Tadahiko Shien
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  2. Sadako Akashi-Tanaka
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  3. Kunihisa Miyakawa
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  4. Takashi Hojo
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  8. Tsutomu Kohno
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  10. Hiroyoshi Doihara
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  11. Noriyuki Katsumata
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  13. Takayuki Kinoshita
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Corresponding author

Correspondence to Tadahiko Shien.

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Shien, T., Akashi-Tanaka, S., Miyakawa, K. et al. Clinicopathological Features of Tumors as Predictors of the Efficacy of Primary Neoadjuvant Chemotherapy for Operable Breast Cancer. World J Surg 33, 44–51 (2009). https://doi.org/10.1007/s00268-008-9800-9

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  • DOI: https://doi.org/10.1007/s00268-008-9800-9

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