Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon

Introduction. Breast cancer is considered nowadays the most prevalent cancer worldwide. The molecular era has successfully divided breast cancer into subtypes based on the various hormonal receptors. These molecular subtypes play a major role in determining the neoadjuvant chemotherapy to be adminis...

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Main Authors: Ali Atoui, Maroun Bou Zerdan, Ahmad El Mahmoud, Nathalie Chamseddine, Lina Hamad, Hazem I. Assi
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Breast Cancer
Online Access:http://dx.doi.org/10.1155/2022/1218128
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author Ali Atoui
Maroun Bou Zerdan
Ahmad El Mahmoud
Nathalie Chamseddine
Lina Hamad
Hazem I. Assi
author_facet Ali Atoui
Maroun Bou Zerdan
Ahmad El Mahmoud
Nathalie Chamseddine
Lina Hamad
Hazem I. Assi
author_sort Ali Atoui
collection DOAJ
description Introduction. Breast cancer is considered nowadays the most prevalent cancer worldwide. The molecular era has successfully divided breast cancer into subtypes based on the various hormonal receptors. These molecular subtypes play a major role in determining the neoadjuvant chemotherapy to be administered. It was noted that the use of neoadjuvant chemotherapy was associated with higher achievement of pathological complete response. The aim of the study was to determine the predictive role of breast cancer subtypes in the efficacy and prognosis of neoadjuvant chemotherapy regimens. Methods. Combining dose dense anthracycline-based, regular dose anthracycline-based, and nonanthracycline-based chemotherapy, we observed data from 87 patients with breast cancer who received surgery after administration of neoadjuvant chemotherapy at our institution between January 2015 and July 2018. The patients were classified into luminal A, luminal B, HER2 overexpression, and triple negative breast cancer as well as low Ki67 (≤14%) and high Ki67 (>14%) expression groups using immunohistochemistry. Pathologic complete response was the only neoadjuvant chemotherapy outcome parameter. To evaluate variables associated with pathologic complete response, we used univariate analyses followed by multivariate logistic regression. Results. 87 patients with breast cancer were classified into different subtypes according to the 12th St. Gallen International Breast Cancer Conference. The response rate to neoadjuvant chemotherapy was significantly different (p=0.046) between the subgroups. There were significant correlations between pathological complete response (pCR) and ER status (p<0.0001), HER2 (p=0.013), molecular subtypes (p=0.018), T stage (p=0.024), N stage before chemotherapy (p=0.04), and type of chemotherapy (p=0.029). Luminal B type patients had the lowest pCR, followed by luminal A type patients. Conclusion. Evaluating molecular subtype’s significance in breast cancer prognosis warrants additional studies in our region with extensive data about patient-specific neoadjuvant chemotherapy regimens. Our study was able to reproduce results complementary to those present in the literature in other outcomes.
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spelling doaj-art-145a3f35a74b4efb8c3ca0bc1e4646ec2025-08-20T03:54:33ZengWileyInternational Journal of Breast Cancer2090-31892022-01-01202210.1155/2022/1218128Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in LebanonAli Atoui0Maroun Bou Zerdan1Ahmad El Mahmoud2Nathalie Chamseddine3Lina Hamad4Hazem I. Assi5Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineFaculty of MedicineDepartment of Internal MedicineIntroduction. Breast cancer is considered nowadays the most prevalent cancer worldwide. The molecular era has successfully divided breast cancer into subtypes based on the various hormonal receptors. These molecular subtypes play a major role in determining the neoadjuvant chemotherapy to be administered. It was noted that the use of neoadjuvant chemotherapy was associated with higher achievement of pathological complete response. The aim of the study was to determine the predictive role of breast cancer subtypes in the efficacy and prognosis of neoadjuvant chemotherapy regimens. Methods. Combining dose dense anthracycline-based, regular dose anthracycline-based, and nonanthracycline-based chemotherapy, we observed data from 87 patients with breast cancer who received surgery after administration of neoadjuvant chemotherapy at our institution between January 2015 and July 2018. The patients were classified into luminal A, luminal B, HER2 overexpression, and triple negative breast cancer as well as low Ki67 (≤14%) and high Ki67 (>14%) expression groups using immunohistochemistry. Pathologic complete response was the only neoadjuvant chemotherapy outcome parameter. To evaluate variables associated with pathologic complete response, we used univariate analyses followed by multivariate logistic regression. Results. 87 patients with breast cancer were classified into different subtypes according to the 12th St. Gallen International Breast Cancer Conference. The response rate to neoadjuvant chemotherapy was significantly different (p=0.046) between the subgroups. There were significant correlations between pathological complete response (pCR) and ER status (p<0.0001), HER2 (p=0.013), molecular subtypes (p=0.018), T stage (p=0.024), N stage before chemotherapy (p=0.04), and type of chemotherapy (p=0.029). Luminal B type patients had the lowest pCR, followed by luminal A type patients. Conclusion. Evaluating molecular subtype’s significance in breast cancer prognosis warrants additional studies in our region with extensive data about patient-specific neoadjuvant chemotherapy regimens. Our study was able to reproduce results complementary to those present in the literature in other outcomes.http://dx.doi.org/10.1155/2022/1218128
spellingShingle Ali Atoui
Maroun Bou Zerdan
Ahmad El Mahmoud
Nathalie Chamseddine
Lina Hamad
Hazem I. Assi
Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
International Journal of Breast Cancer
title Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
title_full Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
title_fullStr Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
title_full_unstemmed Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
title_short Clinical Significance of Breast Cancer Molecular Subtypes and Ki67 Expression as a Predictive Value for Pathological Complete Response following Neoadjuvant Chemotherapy: Experience from a Tertiary Care Center in Lebanon
title_sort clinical significance of breast cancer molecular subtypes and ki67 expression as a predictive value for pathological complete response following neoadjuvant chemotherapy experience from a tertiary care center in lebanon
url http://dx.doi.org/10.1155/2022/1218128
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