ABSTRACT
OBJECTIVE: To evaluate the pathologic response after neoadjuvant chemotherapy in patients with breast cancer according to the stromal tumor-infiltrating lymphocytes (TILs) as well as the evaluation of overall and disease-free survival according to TILs. METHODS: A six years (2008-2013) review was done including patients with locally advanced breast cancer that received neoadjuvant therapy and then surgery. An evaluation of the percentage of TILs was done in the pretreatment biopsies and a correlation analysis and survival curves were done. RESULTS: 187 patients were evaluated. The pathological complete response (pCR) in patients with TILs ≥30% was 58.5%, and in patients with TILsâ¯<â¯30% was 11% (p <0.001). An Odds Ratio of 8.85 was obtained in patients with TILs ≥30% to achieve a pCR. This relationship was seen in patients with HER2-enriched and triple-negative subtypes. No correlation between TILs and survival was obtained (OS: log-rank; p = 0.834; DFS: log-rank; p = 0.937). CONCLUSIONS: The study of TILs is important because they represent an additional tool to predict the response to neoadjuvant treatment mostly in HER2-enriched and triple-negative subtypes of breast cancer.
Subject(s)
Antineoplastic Agents/therapeutic use , Breast Neoplasms/diagnosis , Lymphocytes, Tumor-Infiltrating/pathology , Neoplasm Staging/methods , Adult , Aged , Aged, 80 and over , Biopsy , Breast Neoplasms/mortality , Breast Neoplasms/therapy , Female , Humans , Mastectomy/methods , Middle Aged , Neoadjuvant Therapy , Predictive Value of Tests , Prognosis , Retrospective Studies , Survival Rate/trends , Venezuela/epidemiologyABSTRACT
Objetivos. Determinar la distribución de los diferentes fenotipos tumorales del carcinoma mamario en pacientes venezolanas. Caracterizar las variables clinicopatológicas en cada subgrupo y establecer los patrones de supervivencia para cada fenotipo. Pacientes y métodos. Se evaluaron de forma retrospectiva los datos de 266 pacientes con diagnóstico de carcinoma de mama y estudio inmunohistoquímico de la biopsia inicial. Las pacientes fueron clasificadas en 3 grupos de fenotipos tumorales (receptor estrogénico positivo, HER2/neu sobreexpresado y triple negativo). Se determinaron y correlacionaron variables epidemiológicas, clínicas y patológicas.ResultadosLos grupos de fenotipos tumorales estuvieron distribuidos en receptor estrogénico positivo con un 60,9%, triple negativo con un 27,8% y HER2/neu sobreexpresado con un 11,3%. El 92% de las pacientes con fenotipo triple negativo eran de raza negra. La mejor supervivencia correspondió al fenotipo receptor estrogénico positivo, y la peor, al fenotipo triple negativo, aunque las diferencias no fueron significativas. ConclusionesLa distribución fenotípica del cáncer de mama en Venezuela es parecida a la de la literatura general. El subtipo triple negativo, que tuvo la peor supervivencia, aunque no de forma significativa, presentó una incidencia más elevada que la de otros grupos poblacionales. La mayoría de las pacientes en este subgrupo eran de raza negra (AU)
Objectives. To determine the distribution of the distinct breast carcinoma phenotypes in Venezuelan patients, characterize the clinicopathologic variables in each subgroup, and establish survival patterns for each phenotype. Patients and methods. We retrospectively evaluated data from 266 patients diagnosed with breast carcinoma and an immunohistochemical study of the initial biopsy. The patients were classified into 3 groups of tumor phenotypes (estrogen receptor-positive, HER2/neu overexpression and triple-negative). We determined and correlated epidemiological, clinical and pathological variables. ResultsT. he tumor phenotype groups were distributed as follows: estrogen receptor-positive in 60.9%, triple-negative in 27.8%, and HER2/neu overexpression in 11.3%. A total of 92% of the patients with triple-negative phenotype were African American. Survival was best with the estrogen receptor-positive phenotype and worst with the triple-negative phenotype, but these differences were not significant. Conclusions. The phenotypic distribution of breast carcinoma in Venezuela is similar to that reported in the general literature. The incidence of the triple-negative subtype, which showed the worst survival although this result was not significant was higher than in other populations. Most patients in this subgroup were African American (AU)
