Comparison of the performance of four staging systems in determining the prognosis of breast cancer among women undergoing neoadjuvant chemotherapy

Soares, Isabella Cristina Santos; Bello, Marcelo; Bergmann, Anke; Thuler, Luiz Cláudio Santos

doi:10.1007/s10549-020-06077-4

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Among molecular cancer subtypes, luminal B corresponded to 52.2% of the cases, followed by triplenegative at 19.1%, luminal A at 17.8 % and HER2 at 7.8%. In Brazil, luminal subtype B is the most frequent subtype [16,22,23]. However, different incidences between the ve regions of the country are noted.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Node Biopsy After Neoadjuvant Chemotherapy In Breast Cancer: Real Life Results

Bello

Bergmann

Aguiar

et al. 2021

Preprint

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Purpose: compare demographic, clinical and treatment characteristics of women undergoing neoadjuvant chemotherapy (NAC) for breast cancer (BC) treatment according to the axillary approach and analyze factors associated with the indication of sentinel lymph node biopsy (SLNB) in a real-life scenario. Methods: retrospective cohort study in women diagnosed with BC with indication for NAC. Demographic, clinical, tumor, surgical and adjuvant treatment variables were obtained.. A univariate logistic regression was performed to evaluate the independent factors associated with SLNB indication and a multiple model was applied for adjustments. Results: A total of 918 patients were included in this study, 161 (17.5%) of whom underwent SLNB, 105 (11.4%) who underwent SLNB followed by AL and 652 (71.0%) who underwent AL only. Concerning the adjusted model, women in stage III were 95% less likely to be submitted to an SLNB (OR = 0.05 95% CI 0.01-0.17; p<0.001) compared to those in stage I. Women who underwent mastectomies exhibited a 90% lower chance of undergoing SLNB than those who underwent conservative surgery (95% CI 0.06-0.17; p <0.001). Considering NAC responses, cases with no response or presenting disease progression exhibited a 55% lower chance of undergoing SLNB compared to those displaying a total response (OR = 0.45 95% CI 0.24-0.82; p = 0.009). Conclusion: SLNB was performed in 29% of the patients following NAC. Patients presenting a more advanced clinical stage of the disease with a worse NAC response and those who underwent mastectomies were less likely to undergo SLNB.

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Section: Discussionmentioning

confidence: 99%

Sentinel Node Biopsy After Neoadjuvant Chemotherapy In Breast Cancer: Real Life Results

Bello

Bergmann

Aguiar

et al. 2021

Preprint

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“…The superior performance of CPS + EG or Neo-Bioscore over PS and CS has been demonstrated in the American and Japanese breast cancer patients receiving NAC (4,5). However, the PS, CPS + EG, and Neo-Bioscore staging systems were proven to be equivalent in predicting Brazilian patients' prognosis (6). Another study based on a Chinese population also did not observe the advantages of CPS + EG and Neo-Bioscore over PS (7).…”

Section: Introductionmentioning

confidence: 99%

External verification and improvement of the Neo-Bioscore staging system in a Chinese cohort

Geng¹,

Min²,

Zheng³

et al. 2022

Ann Transl Med

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Background: Accurately predicting outcomes for patients with breast cancer receiving neoadjuvant chemotherapy (NAC) is critical for clinical decisions. Prognostic models applicable to the Chinese population remain limited. The Neo-Bioscore staging system has been utilized as a predictive model for survival of breast cancer patients after NAC. This study aimed to validate the applicability of Neo-Bioscore in a Chinese population and develop an improved staging system based on it to predict prognosis of Chinese patients more accurately. Methods: This study retrospectively collected clinicopathological and survival data in patients receiving NAC from February 2005 to August 2018 in PLA General Hospital. Discrimination, calibration and clinical usefulness were used to assess model performance. Univariate and multivariate analyses assessed relationships between clinicopathological factors and disease-specific survival. For model modification, postoperative pathological staging in the Neo-Bioscore was substituted with the posttreatment pathological tumor (ypT) stage and posttreatment pathological lymph node (ypN) stage. Neo-Bioscore and Modified Neo-Bioscore were compared with the American Joint Committee on Cancer (AJCC) staging system.Results: A total of 436 patients with a median follow-up of 67 months were included. Five-year diseasespecific survival (DSS), overall survival, and disease-free survival rates were 88.0%, 87.9%, and 76.8%, respectively. The concordance index (C-index) of the Neo-Bioscore staging system, posttreatment pathological stage (PS), and pretreatment clinical stage (CS) for DSS were 0.78 [95% confidence interval (CI): 0.72-0.83], 0.75 (95% CI: 0.69-0.82), and 0.68 (95% CI: 0.62-0.74), respectively. No significant difference between the Neo-Bioscore and PS was observed in the C-index (P=0.399). ypT and ypN were included in Neo-Bioscore to replace PS and create a modified staging system named MNeo-Bioscore. The C-index for DSS of the MNeo-Bioscore was 0.82 (95% CI: 0.78-0.87), and the calibration curve and decision curve analysis (DCA) curve performed well in internal validation. Conclusions:The Neo-Bioscore staging system provided precise prognostic stratification for Chinese breast cancer patients receiving NAC; ypN and ypT stage may be substituted for PS to add significant prognostic value for Neo-Bioscore.

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Sentinel Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer: Real Life Results

Bello,

Bergmann,

Aguiar

et al. 2024

Rev. Bras. Cancerol.

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Introdução: O câncer de mama (CM) é o mais comum entre as mulheres. A quimioterapia neoadjuvante (QTNEO) visa melhorar as condições cirúrgicas em pacientes com CM localmente avançado. Objetivo: Comparar as características demográficas, clínicas e de tratamento de mulheres submetidas à QTNEO para tratamento de CM de acordo com a linfadenectomia axilar (LA) ou biópsia de linfonodo sentinela (BLS) e analisar os fatores associados à indicação de BLS em um cenário da vida real. Método: Estudo de coorte retrospectivo em mulheres com CM e indicação de QTNEO. Foram obtidas variáveis demográficas, clínicas, tumorais e de tratamento. Foi realizada regressão logística simples e múltipla para avaliar os fatores independentes associados à indicação de BLS. Resultados: Foram incluídas 918 pacientes, das quais 17,5% foram submetidas à BLS e 11,4% à BLS seguida de LA. As mulheres em estádio III tiveram 95% menos probabilidade de serem submetidas à BLS (OR = 0,05; IC 95%: 0,01-0,17; p < 0,001) em comparação com aquelas no estádio I. As submetidas à mastectomia apresentaram 90% menor chance de realizar BLS do que aquelas com cirurgia conservadora (IC95%: 0,06-0,17; p < 0,001). Considerando as respostas da QTNEO, os casos sem resposta ou com progressão da doença apresentaram chance 55% menor de serem submetidos à BLS em comparação às que apresentaram resposta total (OR = 0,45; IC 95%: 0,24-0,82; p = 0,009). Conclusão: A BLS foi realizada em 29% das pacientes após QTNEO. Pacientes que apresentavam estágio clínico mais avançado da doença e pior resposta à QTNEO e as que foram submetidas a mastectomias tiveram menor probabilidade de serem submetidas à BLS.

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Comparison of the performance of four staging systems in determining the prognosis of breast cancer among women undergoing neoadjuvant chemotherapy

Cited by 3 publications

References 17 publications

Sentinel Node Biopsy After Neoadjuvant Chemotherapy In Breast Cancer: Real Life Results

Sentinel Node Biopsy After Neoadjuvant Chemotherapy In Breast Cancer: Real Life Results

External verification and improvement of the Neo-Bioscore staging system in a Chinese cohort

Sentinel Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer: Real Life Results

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