The residual cancer burden index as a valid prognostic indicator in breast cancer after neoadjuvant chemotherapy

Abstract

Purpose The residual cancer burden index (RCB) was proposed as a response evaluation criterion in breast cancer patients treated with Neoadjuvant Chemotherapy (NAC). This study evaluated the relevance of RCB with replase-free survival (RFS). Methods The clinical data of 254 breast cancer patients who received NAC between 2016 and 2020 were retrospectively collected. The relationship between clinicopathologic factors and RFS was evaluated using Cox proportional hazards regression models. RFS estimates were determined by Kaplan–Meier(K-M) analysis and compared using the log-rank test. Multivariate logistic regression analysis was used to evaluate the risk factors associated with RCB. Receiver operating characteristic (ROC) curves showed the potential of the RCB and MP grading systems as biomarkers for RFS. Results At a median follow-up of 52 months, 59 patients(23.23%) developed relapse. Multivariate Cox regression showed that older age (P = 0.022), high Pathologic T stage after NAC (P = 0.023) and a high RCB score(P = 0.003) were risk factors for relapse. The outcomes of the multivariate logistic analysis indicated that RCB 0 (pathologic complete response [pCR]) was associated with HER2-positive patients (P = 0.002) and triple-negative breast cancer (TNBC) patients (P = 0.013). In addition, the RCB and MP scoring systems served as prognostic markers for patients who received NAC, and their area under curves (AUCs) were 0.691 and 0.342, respectively. Conclusion These data suggest that RCB can be equally applied to predict RFS in Chinese patients with NAC. The application of RCB may help guide the selection of treatment strategies.

Successful treatment of enormous locally advanced breast cancer through neoadjuvant chemotherapy and surgical intervention: a case report

“…Additionally, only chronic lymphadenitis was detected in the dissected lymph nodes, with a total of 45 axillary lymph nodes and nine station 3 lymph nodes examined, without any showing malignant cells ( Figure 10 ). The tumor was graded with Miller-Payne 5, indicating that the tumor site sections exhibited an absence of malignant cells, with the presence of vascular fibroelastotic stroma containing macrophages being frequently observed ( 5 ). The absence of tumor cells was further confirmed through negative cytokeratin 7 staining in the postoperative pathology ( Figure 11 ), indicating a pCR, with the absence of residual invasive breast cancer cells as well as the absence of ductal carcinoma in situ (DCIS).…”