Biological Markers and Response to Neoadjuvant Taxane-Based Chemotherapy in Patients with Locally Advanced Breast Cancer

Abstract

Introduction. Biological markers as Her2/neu, p53, and hormonal receptors (HmRs) may be reliable parameters for prognostic assessment of patients of locally advanced breast cancer (LABC). This work aims at assessing the potential value of these biological markers for the prediction of disease outcome after neoadjuvant taxane-based chemotherapy and its implication on the surgical role. Patients and Methods. From March 2006 to September 2011, 95 patients with LABC were treated by neoadjuvant taxane-based chemotherapy given at intervals of 3 weeks. Expression of Her2/neu and p53 was examined in the initial tissue biopsy by using ELISA technique. Status of HmRs was determined using a commercial enzyme immunoassay. Three weeks after the third cycle, patients underwent surgical resection followed by 3 more cycles of taxane-based chemotherapy and radiotherapy as an adjuvant therapy. Relations of Her2/neu overexpression to p53, HmRs, and conventional prognostic factors were analyzed. Results. Median followup was 61 months. The 5-year DFS and OAS rates were significantly higher in patients with positive HmRs than in those with negative HmRs, patients with Her2− than those with Her2+ breast cancer, and patients with intact p53 breast cancer than those with inactive p53. HER-2 overexpression was statistically significant associated with loss of HmR positive immunostaining (P < 0.0001), grade III breast cancer (P < 0.0001), advanced nodal status (P = 0.0039), and younger (<50 years) age (P = 0.0108). Conclusion. Her2/neu overexpression was associated with poor DFS and OAS rates, as it was significantly associated with negative HmR and high grade.

Pathological responses and survival outcomes in patients with locally advanced breast cancer after neoadjuvant chemotherapy: a single-institute experience

“…Also, the incidence of luminal subtype was relatively higher than other reported cohorts (68%), with a relatively lower prevalence of TNBC (16.4%). This is in concordance with previous reports from Egypt [ 8 , 9 ], suggesting a profile of locally advanced breast cancer in Egyptian patients with younger age, more luminal disease, and more advanced clinical T and N stages. This, in part, explains the relatively higher rates of clinical response despite similar pCR rates compared to international studies [ 10 – 12 ].…”

Evaluation of conservative breast surgery after neoadjuvant chemotherapy in breast cancer

“…The current investigation found that 10% of patients exhibited N0, 70% exhibited N1, and 20% had N2. This came to the same conclusion as El-Sayed et al 12 , who found that 20% of cases exhibited N0, 55% exhibited N1, and 25% exhibited N2.…”

Role of conservative breast surgery in locally advanced breast cancer after neoadjuvant chemotherapy

“…This agrees with El-Sayed MI et al, study that stated that 20% of patients had N0, 55% of them had N1 and 25% of them had N2. 13 14,15 In this study 88% of patients had IDC, 2% of patients had ILC and 10% of patients had mixed ductal and lobular carcinoma. This agrees with Mashoori N et al, who stated that 91.2% of patients had IDC and 8.8% of them had ILC and close to the results of Rahman MS et al, study which stated that 80.45% were classified as IDC, 13.64% as ILC and 5.91% as mixed invasive patterns.…”

“…In this study, 88% were ER/PR-positive and 12% were Her2-positive, this doesn't agree with Vieira RA et al, that stated that 61.5% were ER-positive, 52.6% were PR-positive and 23.1% were Her2-positive and close to the results of El-Sayed et al, study who stated that 21% of patients were Her2-positive and very near to results reported by Rahman MS et al, which stated that 69.09% were found estrogen receptor positive tumor. 13,16,19 According to response to chemotherapy, partial response was observed in (82%) of patients, complete response was detected in (14%) of patients and (4%) of them were presented with stationary disease, this agree with Rahman MS et al, study that stated that 18% had CR, 75% had PR and 7% had SD and agree with Salem MA et al, study that stated 9% had complete response, 79% had partial response and 10% had stationary disease and 2% had progressive disease. 15,16 In the present study, 22% of cases were complicated with seroma that was detected clinically and confirmed by U/S and wound infection occurred in 8% of them.…”