The response to neoadjuvant chemotherapy predicts clinical outcome and increases breast conservation in advanced breast cancer

Philip M Spanheimer; Jennifer C Carr; Alexandra Thomas; Sonia L Sugg; Carol E.H Scott-Conner; Junlin Liao; Ronald J Weigel

doi:10.1016/j.amjsurg.2012.10.025

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The response to neoadjuvant chemotherapy predicts clinical outcome and increases breast conservation in advanced breast cancer

Journal article

Open access

Peer reviewed

The response to neoadjuvant chemotherapy predicts clinical outcome and increases breast conservation in advanced breast cancer

Philip M Spanheimer, Jennifer C Carr, Alexandra Thomas, Sonia L Sugg, Carol E.H Scott-Conner, Junlin Liao and Ronald J Weigel

The American journal of surgery, Vol.206(1), pp.2-7

07/2013

DOI: 10.1016/j.amjsurg.2012.10.025

PMCID: PMC3644520

PMID: 23375759

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Abstract

The aim of this study was to determine outcomes in patients with breast cancer treated with neoadjuvant chemotherapy. Seventy-two consecutive patients receiving neoadjuvant chemotherapy for breast cancer were enrolled. Mastectomy was avoided in 46% of patients, and 42% converted to negative nodes after neoadjuvant chemotherapy. Thirteen patients (18%) achieved a pathologic complete response, which was associated with the estrogen receptor (ER)–negative/human epidermal growth factor receptor 2 (Her2)–negative subtype (58%) and was significantly less likely to occur in the ER+/Her2− subtype (2%) (P < .01). Patients with the ER+/Her2+ subtype were most likely to have no response or progression during chemotherapy, compared with those with the ER−/Her2− subtype (50% vs 0%, P = .01). Five-year survival for patients achieving a pathologic complete response was 100%, compared with 74% in the group with partial response and 48% in the group with no response or progression (P = .01). Neoadjuvant chemotherapy for patients with advanced breast cancer provided prognostic information, allowed evaluation of response to chemotherapy, decreased the mastectomy rate, and potentially reduced the need for axillary lymph node dissection.

Neoadjuvant chemotherapy

Mastectomy

Pathologic complete response

Breast cancer

Triple negative

Surgery

Details

Title: Subtitle: The response to neoadjuvant chemotherapy predicts clinical outcome and increases breast conservation in advanced breast cancer
Creators: Philip M Spanheimer - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Jennifer C Carr - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Alexandra Thomas - Department of Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Sonia L Sugg - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Carol E.H Scott-Conner - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Junlin Liao - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Ronald J Weigel - Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.206(1), pp.2-7
DOI: 10.1016/j.amjsurg.2012.10.025
PMID: 23375759
PMCID: PMC3644520
NLM abbreviation: Am J Surg
ISSN: 0002-9610
eISSN: 1879-1883
Publisher: Elsevier Inc
Grant note: NIH grant T32CA148062 Kristen Olewine Milke Breast Cancer Research Fund Health grants RO1CA109294
Language: English
Date published: 07/2013
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Biochemistry and Molecular Biology; Internal Medicine
Record Identifier: 9984025262902771

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