Predicting Pathological Complete Response in Breast Cancer After Two Cycles of Neoadjuvant Chemotherapy by Tumor Reduction Rate: A Retrospective Case-Control Study

Litong Yao; Xiaoyan Liu; Mozhi Wang; Keda Yu; Shouping Xu; Pengfei Qiu; Zhidong Lv; Xinwen Zhang; Yingying Xu

doi:10.4048/jbc.2023.26.e12

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저자정보: Litong Yao (Department of Breast Surgery The First Hospital of China Medical University Shenyang China.) Xiaoyan Liu (Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute Shenyang China) Mozhi Wang (Department of Breast Surgery The First Hospital of China Medical University Shenyang China.) Keda Yu (Department of Breast Surgery Fudan University Shanghai Cancer Center Shanghai China.) Shouping Xu (Department of Breast Surgery Harbin Medical University Cancer Hospital Harbin China.) Pengfei Qiu (Breast Cancer Center Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China.) Zhidong Lv (Breast Center The Affiliated Hospital of Qingdao University Qingdao China.) Xinwen Zhang (Center of Implant Dentistry School and Hospital of Stomatology China Medical University Liaoning Provincial Key Laboratory of Oral Diseases Shenyang China.) Yingying Xu (Department of Breast Surgery The First Hospital of China Medical University Shenyang China.)

저널정보: 한국유방암학회 Journal of Breast Cancer Journal of Breast Cancer Vol.26 No.2

발행연도: 2023.4

수록면: 136 - 151 (16page)

DOI: 10.4048/jbc.2023.26.e12

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Purpose: We aimed to identify effectiveness-associated indicators and evaluate the optimal tumor reduction rate (TRR) after two cycles of neoadjuvant chemotherapy (NAC) in patients with invasive breast cancer. Methods: This retrospective case-control study included patients who underwent at least four cycles of NAC at the Department of Breast Surgery between February 2013 and February 2020. A regression nomogram model for predicting pathological responses was constructed based on potential indicators. Results: A total of 784 patients were included, of whom 170 (21.68%) reported pathological complete response (pCR) after NAC and 614 (78.32%) had residual invasive tumors. The clinical T stage, clinical N stage, molecular subtype, and TRR were identified as independent predictors of pCR. Patients with a TRR > 35% were more likely to achieve pCR (odds ratio, 5.396; 95% confidence interval [CI], 3.299–8.825). The receiver operating characteristic (ROC) curve was plotted using the probability value, and the area under the ROC curve was 0.892 (95% CI, 0.863–0.922). Conclusion: TRR > 35% is predictive of pCR after two cycles of NAC, and an early evaluation model using a nomogram based on five indicators, age, clinical T stage, clinical N stage, molecular subtype, and TRR, is applicable in patients with invasive breast cancer.

#Asian People #Breast Neoplasms #Logistic Models #Mastectomy #Neoadjuvant Therapy

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Litong Yao

소속기관 Department of Breast Surgery The First Hospital of China Medical University Shenyang China.