Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data

ABSTRACT Background Pathological complete response (pCR) has been proven to be related to prognosis. pCR can be further classified as pCR of the breast (bpCR), pCR of axillary lymph nodes (apCR) or pCR of both tumors. The aim of this study was to elucidate the outcomes and clinicopathological charac...

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Main Authors: Danyang Ji, Bo Lan, Jiayu Wang, Fei Ma, Yang Luo, Qing Li, Pin Zhang, Ruigang Cai, Qiao Li, Shanshan Chen, Binghe Xu, Ying Fan
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Thoracic Cancer
Subjects:
Online Access:https://doi.org/10.1111/1759-7714.70035
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author Danyang Ji
Bo Lan
Jiayu Wang
Fei Ma
Yang Luo
Qing Li
Pin Zhang
Ruigang Cai
Qiao Li
Shanshan Chen
Binghe Xu
Ying Fan
author_facet Danyang Ji
Bo Lan
Jiayu Wang
Fei Ma
Yang Luo
Qing Li
Pin Zhang
Ruigang Cai
Qiao Li
Shanshan Chen
Binghe Xu
Ying Fan
author_sort Danyang Ji
collection DOAJ
description ABSTRACT Background Pathological complete response (pCR) has been proven to be related to prognosis. pCR can be further classified as pCR of the breast (bpCR), pCR of axillary lymph nodes (apCR) or pCR of both tumors. The aim of this study was to elucidate the outcomes and clinicopathological characteristics associated with different patterns of pCR. Methods Patients with node‐positive disease who received neoadjuvant chemotherapy between August 2009 and July 2016 and who achieved pCR in axillary lymph nodes, breast or both were included. Multivariate logistic regression was used to identify factors related to different patterns of pCR. Results Among the 271 patients who were included in the study, 42.1% achieved total pCR, 46.1% achieved ApCR, and 11.8% achieved BpCR. Disease‐free survival (DFS) was significantly better in the total pCR group than in the limited pCR groups throughout the entire cohort (p = 0.042). Univariate and multivariate analyses indicated that patients with HR‐negative disease and a high Ki‐67 proliferation index were more likely to achieve total pCR. Patients with earlier T stage disease were more likely to achieve pCR only in the breast. Among patients who achieved limited pCR, there was no significant difference in terms of whether these patients received intensified adjuvant chemotherapy. Conclusions Total pCR is still the best marker for predicting survival benefit in patients receiving neoadjuvant chemotherapy, and total pCR is more likely to be achieved in patients with HR‐negative disease and a high Ki‐67 proliferation index. T stage and N stage may predict apCR and bpCR, respectively.
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spelling doaj-art-e2daa5b44b8c4b68895071c02406da682025-08-20T02:12:25ZengWileyThoracic Cancer1759-77061759-77142025-04-01167n/an/a10.1111/1759-7714.70035Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World DataDanyang Ji0Bo Lan1Jiayu Wang2Fei Ma3Yang Luo4Qing Li5Pin Zhang6Ruigang Cai7Qiao Li8Shanshan Chen9Binghe Xu10Ying Fan11Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaABSTRACT Background Pathological complete response (pCR) has been proven to be related to prognosis. pCR can be further classified as pCR of the breast (bpCR), pCR of axillary lymph nodes (apCR) or pCR of both tumors. The aim of this study was to elucidate the outcomes and clinicopathological characteristics associated with different patterns of pCR. Methods Patients with node‐positive disease who received neoadjuvant chemotherapy between August 2009 and July 2016 and who achieved pCR in axillary lymph nodes, breast or both were included. Multivariate logistic regression was used to identify factors related to different patterns of pCR. Results Among the 271 patients who were included in the study, 42.1% achieved total pCR, 46.1% achieved ApCR, and 11.8% achieved BpCR. Disease‐free survival (DFS) was significantly better in the total pCR group than in the limited pCR groups throughout the entire cohort (p = 0.042). Univariate and multivariate analyses indicated that patients with HR‐negative disease and a high Ki‐67 proliferation index were more likely to achieve total pCR. Patients with earlier T stage disease were more likely to achieve pCR only in the breast. Among patients who achieved limited pCR, there was no significant difference in terms of whether these patients received intensified adjuvant chemotherapy. Conclusions Total pCR is still the best marker for predicting survival benefit in patients receiving neoadjuvant chemotherapy, and total pCR is more likely to be achieved in patients with HR‐negative disease and a high Ki‐67 proliferation index. T stage and N stage may predict apCR and bpCR, respectively.https://doi.org/10.1111/1759-7714.70035breast cancerneoadjuvantnode‐positivepathological complete responseprognosis
spellingShingle Danyang Ji
Bo Lan
Jiayu Wang
Fei Ma
Yang Luo
Qing Li
Pin Zhang
Ruigang Cai
Qiao Li
Shanshan Chen
Binghe Xu
Ying Fan
Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
Thoracic Cancer
breast cancer
neoadjuvant
node‐positive
pathological complete response
prognosis
title Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
title_full Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
title_fullStr Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
title_full_unstemmed Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
title_short Clinicopathological Factors That Predict Different Responses of Breast and Axillary Tumors to Neoadjuvant Chemotherapy and Prognosis Among Patients With Node‐Positive Breast Cancer: Real World Data
title_sort clinicopathological factors that predict different responses of breast and axillary tumors to neoadjuvant chemotherapy and prognosis among patients with node positive breast cancer real world data
topic breast cancer
neoadjuvant
node‐positive
pathological complete response
prognosis
url https://doi.org/10.1111/1759-7714.70035
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