Peter Kern1, Gunter Von Minckwitz2, Carolin Puetter3, Sofia Pavlidou4, Annika Flach4, Rainer Kimmig4, Mahdi Rezai5. 1. Women's Department, West German Cancer Center, University of Duisburg-Essen, University Hospital of Essen, Essen, Germany Peter.Kern@uk-essen.de. 2. German Breast Group, Neu-Isenburg, Germany. 3. Institute for Medical Informatics, Biometry and Epidemiology, Essen, Germany. 4. Women's Department, West German Cancer Center, University of Duisburg-Essen, University Hospital of Essen, Essen, Germany. 5. European Breast Center, Düsseldorf, Germany.
Abstract
AIM: In order to establish a new risk categorization system for triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy, we analyzed a large database including more than 50% of all breast cancer cases nationwide. PATIENTS AND METHODS: From a database of 39,570 primary breast cancer cases, 648 patients with TNBC were treated with neoadjuvant chemotherapy (2009-2011). The primary study end-point was the impact of residual tumor burden on survival. RESULTS: Pathological complete response (pCR) was achieved in 199 patients; 449 patients had a non-pCR (pCR rate=30.8%). Stage ypT1 did not differ prognostically from ypT2, and likewise ypT3 not from ypT4 (in patients with N0 and N1-3 disease). Combined analysis of ypT1/2 and ypT3/4 yielded highly significant differences (p=0.000145). CONCLUSION: A partial response still conveys a substantial survival benefit. There is no linear deterioration of prognosis according to residual tumor size. Post-neoadjuvant TNM stages ypT1 and ypT2, and ypT3 and ypT4 pairwise build uniform prognostic groups in TNBC, when there is no or low axillary lymph-node involvement. Copyright
AIM: In order to establish a new risk categorization system for triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy, we analyzed a large database including more than 50% of all breast cancer cases nationwide. PATIENTS AND METHODS: From a database of 39,570 primary breast cancer cases, 648 patients with TNBC were treated with neoadjuvant chemotherapy (2009-2011). The primary study end-point was the impact of residual tumor burden on survival. RESULTS: Pathological complete response (pCR) was achieved in 199 patients; 449 patients had a non-pCR (pCR rate=30.8%). Stage ypT1 did not differ prognostically from ypT2, and likewise ypT3 not from ypT4 (in patients with N0 and N1-3 disease). Combined analysis of ypT1/2 and ypT3/4 yielded highly significant differences (p=0.000145). CONCLUSION: A partial response still conveys a substantial survival benefit. There is no linear deterioration of prognosis according to residual tumor size. Post-neoadjuvant TNM stages ypT1 and ypT2, and ypT3 and ypT4 pairwise build uniform prognostic groups in TNBC, when there is no or low axillary lymph-node involvement. Copyright
Authors: Haeyoung Kim; Yeon Jeong Kim; Donghyun Park; Woong-Yang Park; Doo Ho Choi; Won Park; Won Kyung Cho; Nalee Kim Journal: Breast Cancer Res Treat Date: 2021-06-21 Impact factor: 4.872