E Montagna1, V Bagnardi2, G Viale3, N Rotmensz4, A Sporchia5, G Cancello5, A Balduzzi5, V Galimberti6, P Veronesi6, A Luini6, M G Mastropasqua7, C Casadio7, C Sangalli5, A Goldhirsch8, M Colleoni5. 1. Division of Medical Senology, European Institute of Oncology, Milan emilia.montagna@ieo.it. 2. Department of Quantitative Methods and Statistics, University of Milan-Bicocca, Milan Division of Epidemiology and Biostatistics. 3. Department of Pathology, European Institute of Oncology, Milan School of Medicine, University of Milan, Milan. 4. Division of Epidemiology and Biostatistics. 5. Division of Medical Senology, European Institute of Oncology, Milan. 6. Division of Senology. 7. Department of Pathology, European Institute of Oncology, Milan. 8. Program of Senology (Breast Health), European Institute of Oncology, Milan, Italy.
Abstract
BACKGROUND: Limited data are available on the prognostic value of changes in the biological features of residual tumours following neoadjuvant therapies in breast cancer patients. PATIENTS AND METHODS: We collected information through the institutional clinical database on all consecutive breast cancer patients treated with neoadjuvant chemotherapy at the European Institute of Oncology (IEO), Milan, Italy, between 1999 and 2011. We selected patients who did not achieve pathological complete response at final surgery. All patients had a pathological evaluation, including ER, PgR, HER2 protein and Ki-67 expression carried out at the IEO both at diagnostic core biopsy and at final surgery. RESULTS: We identified a total of 904 patients. The 5% of patients who were ER positive at diagnostic biopsy had ER-negative residual tumour at final surgery. For PgR expression, 67% of the patients, whose tumours had a PgR >20% at diagnostic biopsy had a PgR <20% at final surgery. The Ki-67 expression changed from >20% to <20% in 40% of the patients. At the multivariate analysis, the decrease of PgR-immunoreactive cells correlated with improved outcome in terms of disease-free survival (DFS) [hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.54-1.00, P 0.046]. In addition, the decrease of Ki-67 expression to <20% of the cells at final surgery was found to be associated with better outcome both in terms of DFS (HR 0.52; 95% CI 0.40-0.68 P < 0.0001) and overall survival (HR 0.45; 95% CI 0.32-0.64, P < 0.0001). CONCLUSION: The decrease of PgR and Ki-67 expression after preoperative chemotherapy has a prognostic role in breast cancer patients with residual disease.
BACKGROUND: Limited data are available on the prognostic value of changes in the biological features of residual tumours following neoadjuvant therapies in breast cancerpatients. PATIENTS AND METHODS: We collected information through the institutional clinical database on all consecutive breast cancerpatients treated with neoadjuvant chemotherapy at the European Institute of Oncology (IEO), Milan, Italy, between 1999 and 2011. We selected patients who did not achieve pathological complete response at final surgery. All patients had a pathological evaluation, including ER, PgR, HER2 protein and Ki-67 expression carried out at the IEO both at diagnostic core biopsy and at final surgery. RESULTS: We identified a total of 904 patients. The 5% of patients who were ER positive at diagnostic biopsy had ER-negative residual tumour at final surgery. For PgR expression, 67% of the patients, whose tumours had a PgR >20% at diagnostic biopsy had a PgR <20% at final surgery. The Ki-67 expression changed from >20% to <20% in 40% of the patients. At the multivariate analysis, the decrease of PgR-immunoreactive cells correlated with improved outcome in terms of disease-free survival (DFS) [hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.54-1.00, P 0.046]. In addition, the decrease of Ki-67 expression to <20% of the cells at final surgery was found to be associated with better outcome both in terms of DFS (HR 0.52; 95% CI 0.40-0.68 P < 0.0001) and overall survival (HR 0.45; 95% CI 0.32-0.64, P < 0.0001). CONCLUSION: The decrease of PgR and Ki-67 expression after preoperative chemotherapy has a prognostic role in breast cancerpatients with residual disease.
Authors: Paula Cabrera-Galeana; Wendy Muñoz-Montaño; Fernando Lara-Medina; Alberto Alvarado-Miranda; Victor Pérez-Sánchez; Cynthia Villarreal-Garza; R Marisol Quintero; Fany Porras-Reyes; Enrique Bargallo-Rocha; Ignacio Del Carmen; Alejandro Mohar; Oscar Arrieta Journal: Oncologist Date: 2018-02-28
Authors: Giulia Galli; Giacomo Bregni; Stefano Cavalieri; Luca Porcu; Paolo Baili; Amash Hade; Francesca Di Salvo; Milena Sant; Roberto Agresti; Massimiliano Gennaro; Secondo Folli; Maria C De Santis; Biagio Paolini; Maria L Carcangiu; Filippo de Braud; Serena Di Cosimo Journal: Breast Care (Basel) Date: 2017-12-12 Impact factor: 2.860