ABSTRACT
OBJECTIVE: To investigate the effect of neoadjuvant chemotherapy on estrogen receptor (ER) and progesterone receptor (PR) expression in breast carcinoma. METHODS: Samples were obtained from 31 patients with breast carcinoma who received neo-adjuvant chemotherapy, ER or PR expressions were analyzed in preoperative core biopsies and final surgical specimens. RESULTS: ER level was up-regulated in 13 (41.9%) out of 31 cases, PR level was up-regulated in 10 (32.3%). Both ER level and PR level were up-regulated in 8 (25.8%) out of 31 cases. CONCLUSIONS: Neoadjuvant chemotherapy may impact the hormone receptor status, ER and PR expression re-analysis in final surgical specimens is recommended.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Neoadjuvant Therapy , Receptors, Estrogen/biosynthesis , Receptors, Progesterone/biosynthesis , Breast Neoplasms/metabolism , Chemotherapy, Adjuvant , Epirubicin/administration & dosage , Female , Follow-Up Studies , Humans , Immunohistochemistry , Paclitaxel/administration & dosageABSTRACT
OBJECTIVE: To investigate the efficacy of neoadjuvant chemotherapy (NCT) and the feasibility of conservative breast surgery after reducing the size of a primary tumor by NCT in patients with operable breast cancer. METHODS: Thirty patients with stage IIB and IIIA breast cancer underwent NCT including epirubicin 60 mg/m(2) by intravenous injection on day 1 and paclitaxel 150 mg/m(2) by 3-hour continuous infusion on day 2 with 21 days as a cycle from July 2001 to April 2003. All patients received 3 - 4 cycles of NCT. Breast conservation treatment or modified mastectomy was performed after the tumor was reduced to less than 3 cm in diameter. The nonresponders received modified mastectomy. RESULTS: The overall response rate (ORR) was 93% (28/30) for the primary tumors of breast, Fifteen patients (50%) obtained clinical complete response (cCR), including 7 cases (23%) with pathologic complete response (pCR). Thirteen cases (43%) achieved clinical partial response (cPR), and 2 (7%) no change (NC). No case showed progression of disease. Twenty-six (87%) cases were downstaged according to the TNM system classification. The median initial tumor size was 4 cm (3 - 10 cm) before NCT and was reduced to 0.8 cm (0 - 6 cm) after NCT. All 30 patients received operation. Eighteen (60%) of them were candidates for breast conserving therapy, and actually only 11 (37%) selected such surgery. CONCLUSION: An effective treatment for operable breast cancer, NCT with epirubicin plus paclitaxel results in significant downstaging or eliminating of primary tumors in breast cancer, thus expanding the indication of breast conservation therapy.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/surgery , Mastectomy, Segmental/methods , Adult , Aged , Breast Neoplasms/drug therapy , Chemotherapy, Adjuvant , Drug Administration Schedule , Epirubicin/administration & dosage , Feasibility Studies , Female , Follow-Up Studies , Humans , Middle Aged , Neoadjuvant Therapy , Paclitaxel/administration & dosageABSTRACT
OBJECTIVE: To investigate the estrogen receptors (ER)alpha and ERbeta expression and their relationship with clinicopathological parameters in human breast carcinoma. METHODS: Samples were obtained from 30 breast carcinoma, reverse transcriptase polymerase chain reaction was used to measure the expression of ERalpha and ERbeta mRNA. RESULTS: ERalpha mRNA level was up-regulated in breast carcinoma tissue compared with adjacent normal tissue (t = 7.399, P < 0.01) while down-regulated in ERbeta. The relative ratio of ERalpha and ERbeta was decreased in normal tissue vs. carcinoma (t = 6.385, P < 0.01), in patients with lymph node metastasis vs. those without lymph node metastasis (t = 2.602, P < 0.05), in late stage carcinoma vs. early stage (t = 3.754, P < 0.05). CONCLUSION: ERalpha and ERbeta play divergent role in the development of human breast carcinoma.
