Relationship Between Pathological Response and Molecular Subtypes in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Abstract

Background: More than half of patients with breast cancer were diagnosed with locally advanced stages of the disease (54%). This study aimed to explain the pathological response received with neoadjuvant chemotherapy (NACT) according to the molecular classification of breast cancer in patients with locally advanced tumors.Methods: One hundred one patients with locally advanced breast cancer treated with neoadjuvant chemotherapy were analyzed. Patients were classified into five molecular subtypes based on the profile of the estrogen receptor, progesterone receptor, HER2, and Ki-67. We determined associations between pathologic complete response and molecular subgroups.Results: Most patients had luminal A tumors (n:28, 27.7%). The overall rate of pathological complete response (pCR) was 34.7% (n:35). Tumors that presented the highest rate of pCR were pure HER2-positive, at 60% (n:6; OR, 3.2; 95% CI, 0.8–12.2). According to logistic regression analysis, the factors affecting pCR were HER2 positivity and clinically positive axilla before NACT. Luminal A tumors had a significantly lower pCR rate. (7.1%,p: 0.001). Despite the low pCR rate, luminal A tumor survival was the best subgroup (p< 0.001). However, there was no difference between EFS and OS according to pCR in any molecular subgroups.Conclusion: Pathological complete response is directly related to the subtypes of breast cancer. A high rate of complete pathological response is observed in the pure HER2-positive group. However, EFS and OS were not statistically significant in patients with and without pCR.