Prognosis and efficacy of neoadjuvant chemotherapy in patients with invasive micro-papillary carcinoma of breast / 中国肿瘤临床

ABSTRACT

Objective: To investigate the prognosis of patients who receive neoadjuvant chemotherapy (NAC) for invasive micropapillary carcinoma (IMPC) of the breast using a propensity score matching (PSM) method and to analyze the effects of NAC. Methods: Clinical and pathological data of a total of 251 cases of IMPC of the breast were collected for this study, from January 2011 to March 2014 in Tianjin Medical University Cancer Institute and Hospital, of which the NAC group comprised 67 cases and the non-NAC group comprised 184 cases. Tumor sizes before and after NAC were compared in the NAC group. Prognostic differences were compared between the NAC group and non-NAC group before and after PSM balancing the baseline. Results: The mean value of the maximum dimensions significantly reduced from 5.0cm to 4.2cm in the NAC group after NAC (P=0.035), but there was no statistically significant difference in T stage changes (P=0.064). A total of 49 pairs of patients were matched after PSM, and differences in the baseline data of the paired group were not significant. Univariate survival analysis showed no significant difference in the recurrence-free survival (RFS) rate between the NAC group (77.6% vs. 89.2%) and non-NAC group (72.1% vs. 91.0%) before and after PSM (all P>0.05). The 5-year distant metastasis-free survival (DMFS) rates in the NAC group before and after PSM were 53.4% and 50.0%, respectively, which were both significantly lower than those in the non-NAC group 69.1%, 59.2% (all P<0.05), and multivariate survival analysis showed that undergoing NAC was an independent prognostic factor of DMFS after PSM. Conclusion: Breast IMPC is a special type of tumor that is not sensitive to chemotherapy. Although some tumors decrease after NAC, IMPC patients do not benefit from NAC in terms of RFS; NAC may even increase the risk of distant metastasis. Therefore, IMPC patients should undergo surgical treatment as soon as possible, and NAC is not recommended.