Conversion rate from mastectomy to breast conservation after neoadjuvant dual target therapy for HER2-positive breast cancer in the Asian population

Chang, Yuk-Kwan; Co, Michael; Kwong, Ava

doi:10.1007/s12282-019-01037-3

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…Our result is in line with previous reports, although Gonzales et al reported a higher percentage of breast-conservation [ 20 ]. It may also be influenced by other factors than resectability [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Pathologic Complete Response Rates After Neoadjuvant Pertuzumab and Trastuzumab with Chemotherapy in Early Stage HER2-Positive Breast Cancer - Increasing Rates of Breast Conserving Surgery: A Real-World Experience

Boér

Kahán

Littmann

et al. 2021

Pathol. Oncol. Res.

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Purpose: The neoadjuvant use of pertuzumab and trastuzumab with chemotherapy improves the pathologic complete response (pCR) in early HER2+ breast cancer. The aim of this study was to determine the pCR rate obtained with dual HER2 blockade in routine clinical practice. The secondary and tertiary objective was to investigate the impact of neoadjuvant systemic therapy (NST) on performing breast-conserving surgery and survival data.Methods: This was a multicentre, retrospective, observational study in patients with stage II and III HER2+ early breast cancer who received pertuzumab and trastuzumab-based NST. Data were collected from patients’ medical records.Results: Eighty-two patients were included in the study treated in 8 cancer centers in Hungary between March 2015 and January 2020. The study included women with a median age of 50.3 years. The majority of the patients (95%) received a sequence of anthracycline-based chemotherapy followed by docetaxel. pCR was achieved in 54% of the cases. As a result of NST a significant increase of conservative breast surgeries (33% vs. 3.6% planned, p = 0.0001) was observed. Ki67 expression and neutrophil-to-lymphocyte ratio (NLR) significantly predicted pCR. None of the variables were independent predictors of DFS.Conclusion: The pCR rate achieved in our study demonstrates the reproducibility of trial data in a real-world population. The rate of breast-conserving surgery was significantly increased.

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Section: Discussionmentioning

confidence: 99%

Pathologic Complete Response Rates After Neoadjuvant Pertuzumab and Trastuzumab with Chemotherapy in Early Stage HER2-Positive Breast Cancer - Increasing Rates of Breast Conserving Surgery: A Real-World Experience

Boér

Kahán

Littmann

et al. 2021

Pathol. Oncol. Res.

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“… 14 The conversion rate from mastectomy to BCS was more than 50% after NACT plus dual-target therapy in the Asian population. 53 In our data, of 45 patients who received NACT plus target therapies, eight patients received dual blockade anti-HER2 therapy and six patients achieved pCR and then were treated with BCS.…”

Section: Discussionmentioning

confidence: 75%

Neoadjuvant Therapy in Nonmetastatic Breast Cancer in Kurdistan, Iraq

Namiq

Sulaiman

2023

JCO Global Oncology

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PURPOSE The core management of nonmetastatic breast cancer includes surgical tumor removal by either breast-conserving surgery (BCS) or mastectomy. The use of neoadjuvant chemotherapy (NACT) has shown the potential to downstage locally advanced breast cancer (LABC) and reduce the extent of breast or axillary surgery. This study aimed to assess the treatment approach for nonmetastatic breast cancer in the Kurdistan region of Iraq and to compare its alignment with the current international recommendations for cancer treatment. METHODS We retrospectively reviewed the records of 1,000 patients with prespecified eligible inclusion criteria who underwent either BCS or mastectomy for nonmetastatic invasive breast cancer at oncology centers in the Kurdistan region of Iraq between the period 2016 and 2021. RESULTS Of 1,000 patients (median age, 47 years [range, 22-85 years]), 60.2% underwent mastectomy and 39.8% underwent BCS. The proportion of patients treated with NACT has increased over time, with 8.3% of patients receiving neoadjuvant treatment in 2016 compared with 14.2% in 2021. Similarly, BCS increased from 36.3% in 2016 to 43.7% in 2021. Most patients who underwent BCS had early breast cancer with low nodal involvement burden. CONCLUSION The increasing trends of BCS practice in LABC along with the increased use of NACT in the Kurdistan region in recent years comply with international guidelines. Our large multicenter, real-life series emphasizes the need to implement and discuss more conservative surgical approaches, enhanced with the broader use of NACT, through education and information programs for health providers and patients, in the context of multidisciplinary team discussions, to deliver high-quality, patient-centric breast cancer care.

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“…Studies have documented an increase in the utilization of BCS following neoadjuvant treatment and the gradual expansion of treatment options to less toxic targeted therapies 50 . The conversion rate from mastectomy to BCS exceeded 50% after neoadjuvant chemotherapy (NACT) plus dual-target therapy in the Asian population 51 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of clinicopathologic characteristics and survival outcomes of various subtypes of breast cancer

Zangouri,

Balaneji,

Deylami

et al. 2024

Preprint

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Background Breast cancer is often classified into subtypes using immunohistochemical markers. This study aimed to compare the histopathological features, prognostic indicators, and clinical outcomes of diverse breast cancer subtypes. Patients and methods: A retrospective study was undertaken and all patients of various subtype of breast cancer over a 5 year period were included. Clinicopathological characteristics, including tumor size, lymph node (LN) metastasis, histological grade, immunohistochemical markers (estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2neu status), TNM staging, lymphovascular invasion (LVI), perineural invasion (PNI), and overall survival (OS),and Disease free survival(DFS) were comprehensively evaluated. Results Of the 9310 individuals diagnosed with breast cancer, a vast majority (99.4%) was females. Patients with invasive papillary carcinoma tumor subtypes presented with an older mean age (57.24 ± 12.92) years. Tumor grade exhibited a statistically significant correlation with tumor subtype (P < 0.001). Invasive lobular carcinoma (94.8%), IPC (94.3%), and mucinous carcinoma (93.6%) demonstrated excellent OS rates in stages I, II, and III. However, ICMP (94.6%) exhibited superior OS in stages II and III. In terms of DFS, IPC (94.2%), mucinous carcinoma (94.5%), and ICMP (93.6%) showed favorable DFS rates in TNM stages 1 and 2, with ICMP maintaining exceptional DFS rates in stage 3. Conclusion Invasive carcinoma with medullary features has the highest DFS rate across all stages, while mucinous and invasive papillary carcinoma have the highest DFS rates in TNM stage 1. Mucinous tumors have the highest DFS rates in TNM stage 2, followed by invasive carcinoma with medullary features. Invasive lobular carcinoma, invasive papillary carcinoma, and mucinous tumors had excellent overall survival (OS) rates in stages I, II, and III. Invasive carcinoma with medullary features had superior OS in stages II and III.

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Conversion rate from mastectomy to breast conservation after neoadjuvant dual target therapy for HER2-positive breast cancer in the Asian population

Cited by 6 publications

References 16 publications

Pathologic Complete Response Rates After Neoadjuvant Pertuzumab and Trastuzumab with Chemotherapy in Early Stage HER2-Positive Breast Cancer - Increasing Rates of Breast Conserving Surgery: A Real-World Experience

Pathologic Complete Response Rates After Neoadjuvant Pertuzumab and Trastuzumab with Chemotherapy in Early Stage HER2-Positive Breast Cancer - Increasing Rates of Breast Conserving Surgery: A Real-World Experience

Neoadjuvant Therapy in Nonmetastatic Breast Cancer in Kurdistan, Iraq

Comparison of clinicopathologic characteristics and survival outcomes of various subtypes of breast cancer

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