Impact of Neoadjuvant Chemotherapy and Pathological Response on Patient Outcomes: A Single Centre Study
Association of Breast Surgery ePoster Library. Williams S. 05/15/17; 166311; P173
Ms. Sophie Williams
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Abstract
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Introduction: Neoadjuvant chemotherapy (NAC) is selected to obtain tumour volume reduction (TVR) or facilitate breast conserving surgery (BCS). NAC may result in pathologic complete response (pCR) with rates cited between 3-20%. Local outcomes over a 6-year period were retrospectively analysed and compared with literature.
Methods: All patients receiving NAC for breast cancer between 2010 and 2015 were identified via the “Somerset” cancer database. The aims of NAC were pre-defined as tumour downsizing to enable BCS or TVR followed by Mastectomy. Data was obtained through electronic records and case notes. NAC regimens were identified using ChemoCare database. Radiological tumour size was compared pre and post-NAC and pathological response verified. Results were analysed using Microsoft Excel and SPSS.
Results: 46 patients (mean 55.5years) received NAC, of which 67% were node positive, 48% Grade 3, 22% HER-2 positive, and 11% (5/46) Triple Negative. Mean radiological pre-NAC size was 45mm, post-NAC 21mm (53% reduction, p<0.00001). Mean post-NAC pathological size was 24.7mm. BCS was performed in 28% (13/46). Overall pCR rate was 15% (7/46), of which 6/7 were initially node positive. The Triple Negative group attained a pCR of 20% (1/5). Mean patient follow-up 3.7 years (1.4-6.8yrs). Local relapse rate 15%; distant relapse 26%. Breast cancer-related mortality rate was 15% (7/46). No mortality or relapse in pCR group.
Conclusions: NAC significantly reduced tumour size (p<0.00001). pCR rate compares favourably with literature at 15%. Lymph node pCR may be associated with better disease-free and overall survival; longer follow-up is required in this subset.
Methods: All patients receiving NAC for breast cancer between 2010 and 2015 were identified via the “Somerset” cancer database. The aims of NAC were pre-defined as tumour downsizing to enable BCS or TVR followed by Mastectomy. Data was obtained through electronic records and case notes. NAC regimens were identified using ChemoCare database. Radiological tumour size was compared pre and post-NAC and pathological response verified. Results were analysed using Microsoft Excel and SPSS.
Results: 46 patients (mean 55.5years) received NAC, of which 67% were node positive, 48% Grade 3, 22% HER-2 positive, and 11% (5/46) Triple Negative. Mean radiological pre-NAC size was 45mm, post-NAC 21mm (53% reduction, p<0.00001). Mean post-NAC pathological size was 24.7mm. BCS was performed in 28% (13/46). Overall pCR rate was 15% (7/46), of which 6/7 were initially node positive. The Triple Negative group attained a pCR of 20% (1/5). Mean patient follow-up 3.7 years (1.4-6.8yrs). Local relapse rate 15%; distant relapse 26%. Breast cancer-related mortality rate was 15% (7/46). No mortality or relapse in pCR group.
Conclusions: NAC significantly reduced tumour size (p<0.00001). pCR rate compares favourably with literature at 15%. Lymph node pCR may be associated with better disease-free and overall survival; longer follow-up is required in this subset.
Introduction: Neoadjuvant chemotherapy (NAC) is selected to obtain tumour volume reduction (TVR) or facilitate breast conserving surgery (BCS). NAC may result in pathologic complete response (pCR) with rates cited between 3-20%. Local outcomes over a 6-year period were retrospectively analysed and compared with literature.
Methods: All patients receiving NAC for breast cancer between 2010 and 2015 were identified via the “Somerset” cancer database. The aims of NAC were pre-defined as tumour downsizing to enable BCS or TVR followed by Mastectomy. Data was obtained through electronic records and case notes. NAC regimens were identified using ChemoCare database. Radiological tumour size was compared pre and post-NAC and pathological response verified. Results were analysed using Microsoft Excel and SPSS.
Results: 46 patients (mean 55.5years) received NAC, of which 67% were node positive, 48% Grade 3, 22% HER-2 positive, and 11% (5/46) Triple Negative. Mean radiological pre-NAC size was 45mm, post-NAC 21mm (53% reduction, p<0.00001). Mean post-NAC pathological size was 24.7mm. BCS was performed in 28% (13/46). Overall pCR rate was 15% (7/46), of which 6/7 were initially node positive. The Triple Negative group attained a pCR of 20% (1/5). Mean patient follow-up 3.7 years (1.4-6.8yrs). Local relapse rate 15%; distant relapse 26%. Breast cancer-related mortality rate was 15% (7/46). No mortality or relapse in pCR group.
Conclusions: NAC significantly reduced tumour size (p<0.00001). pCR rate compares favourably with literature at 15%. Lymph node pCR may be associated with better disease-free and overall survival; longer follow-up is required in this subset.
Methods: All patients receiving NAC for breast cancer between 2010 and 2015 were identified via the “Somerset” cancer database. The aims of NAC were pre-defined as tumour downsizing to enable BCS or TVR followed by Mastectomy. Data was obtained through electronic records and case notes. NAC regimens were identified using ChemoCare database. Radiological tumour size was compared pre and post-NAC and pathological response verified. Results were analysed using Microsoft Excel and SPSS.
Results: 46 patients (mean 55.5years) received NAC, of which 67% were node positive, 48% Grade 3, 22% HER-2 positive, and 11% (5/46) Triple Negative. Mean radiological pre-NAC size was 45mm, post-NAC 21mm (53% reduction, p<0.00001). Mean post-NAC pathological size was 24.7mm. BCS was performed in 28% (13/46). Overall pCR rate was 15% (7/46), of which 6/7 were initially node positive. The Triple Negative group attained a pCR of 20% (1/5). Mean patient follow-up 3.7 years (1.4-6.8yrs). Local relapse rate 15%; distant relapse 26%. Breast cancer-related mortality rate was 15% (7/46). No mortality or relapse in pCR group.
Conclusions: NAC significantly reduced tumour size (p<0.00001). pCR rate compares favourably with literature at 15%. Lymph node pCR may be associated with better disease-free and overall survival; longer follow-up is required in this subset.
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