Abstract
The hormone receptor (HR) status and human epidermal growth hormone receptor 2 (HER2) status of patients with breast cancer may change following neoadjuvant chemotherapy (NCT). This prospective observational study aimed to evaluate the prognostic impact of receptor conversion in breast cancer patients treated with NCT.Of the 423 consecutive patients who had residual disease in the breast after NCT, 55 (13.0%) changed from HR (+) to HR (-), 23 (5.4%) changed from HR (-) to HR (+), 27 (6.4%) changed from HER2 (+) to HER2 (-), and 13 (3.1%) changed from HER2 (-) to HER2 (+). A total of 54 (12.8%) changed to the triple-negative (TN) tumor phenotype. The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis. Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS. In conclusion, patients with breast cancer may experience changes in HR status, HER2 status and tumor phenotype after NCT. The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome.
Keywords:
breast cancer; neoadjuvant chemotherapy; prognosis; receptor conversion.
Publication types
-
Comparative Study
-
Observational Study
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Adult
-
Aged
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
-
Breast Neoplasms / chemistry
-
Breast Neoplasms / drug therapy*
-
Breast Neoplasms / mortality
-
Breast Neoplasms / therapy
-
Carboplatin / administration & dosage
-
Combined Modality Therapy
-
Cyclophosphamide / administration & dosage
-
Disease-Free Survival
-
Epirubicin / administration & dosage
-
Estrogens*
-
Female
-
Fluorouracil / administration & dosage
-
Humans
-
Kaplan-Meier Estimate
-
Male
-
Middle Aged
-
Neoadjuvant Therapy*
-
Neoplasm Proteins / analysis*
-
Neoplasms, Hormone-Dependent / chemistry
-
Neoplasms, Hormone-Dependent / drug therapy*
-
Neoplasms, Hormone-Dependent / therapy
-
Progesterone*
-
Prognosis
-
Proportional Hazards Models
-
Prospective Studies
-
Receptor, ErbB-2 / analysis*
-
Receptors, Estrogen / analysis*
-
Receptors, Progesterone / analysis*
-
Taxoids / administration & dosage
-
Triple Negative Breast Neoplasms / chemistry
-
Triple Negative Breast Neoplasms / drug therapy
-
Triple Negative Breast Neoplasms / mortality
-
Triple Negative Breast Neoplasms / therapy
-
Vinblastine / administration & dosage
-
Vinblastine / analogs & derivatives
-
Vinorelbine
Substances
-
Estrogens
-
Neoplasm Proteins
-
Receptors, Estrogen
-
Receptors, Progesterone
-
Taxoids
-
Epirubicin
-
Progesterone
-
Vinblastine
-
Cyclophosphamide
-
Carboplatin
-
ERBB2 protein, human
-
Receptor, ErbB-2
-
Vinorelbine
-
Fluorouracil