Analysis of the factors influencing the pathological complete remission and prognosis of young breast cancer patients after neoadjuvant chemotherapy / 中国综合临床

ABSTRACT

Objective:To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy.Methods:From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS).Results:After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ 2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ 2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ 2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS ( HR(95% CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS ( HR(95% CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant ( P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant( P= 0.026). Conclusion:The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected by many clinicopathological factors.