Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy

Inari, Hitoshi; Teruya, Natsuki; Kishi, Miki; Horii, Rie; Akiyama, Futoshi; Takahashi, Shunji; Ito, Yoshinori; Ueno, Takayuki; Iwase, Takuji; Ohno, Shinji

doi:10.3390/cancers12092633

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Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy

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Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan

Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10 Konandai, Konan-ku, Yokohama 234-8503, Japan

Department of Pathology, Saitama Cancer Center, 780 Ina-machi, Saitama 362-0806, Japan

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Department of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan

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Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan

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Breast Center, Japanese Red Cross Nagoya Daiichi Hospital, 3-35 Michishitacho, Nakamura-ku, Nagoya 453-8511, Japan

Author to whom correspondence should be addressed.

Cancers 2020, 12(9), 2633; https://doi.org/10.3390/cancers12092633

Received: 27 August 2020 / Revised: 8 September 2020 / Accepted: 11 September 2020 / Published: 15 September 2020

(This article belongs to the Special Issue Neoadjuvant Systemic Therapy in Early Breast Cancer)

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It is unknown whether patients with cytologically proven axillary node-positive breast cancer, who achieve axillary pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) have a comparable prognosis to patients with axillary pathological node-negative disease (pN-) without NAC. The aim of this retrospective study was to clarify the clinical impact of axillary pCR after NAC on survival and to compare survival outcomes between breast cancer patients with axillary pCR, and those with axillary pN- without NAC, using propensity score matching to adjust for baseline characteristics other than nodal status. Axillary pCR after NAC was associated with improved prognosis in patients with axillary node-positive disease, and patients with axillary pCR and matched pairs with axillary pN- without NAC had comparable outcomes.

Abstract

Background: It is unknown whether patients with cytologically proven axillary node-positive breast cancer who achieve axillary pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) have comparable prognosis to patients with axillary pathological node-negative disease (pN-) without NAC. Methods: We retrospectively reviewed the data of patients with cytologically proven axillary node-positive disease who received NAC and those with axillary pN- without NAC for control between January 2007 and December 2012. We compared outcomes according to response in the axilla to NAC and between patients with axillary pCR and matched pairs with axillary pN- without NAC using propensity scores. Results: We included 596 patients with node-positive breast cancer who received NAC. The median follow-up period was 64 months. Patients with axillary pCR showed significantly better distant disease-free survival (DDFS) and overall survival (OS) than patients with residual axillary disease (both p < 0.01). There was no significant difference in DDFS and OS between patients with axillary pCR and matched pairs with axillary pN- without NAC. Conclusion: Axillary pCR was associated with improved prognosis. Patients with axillary pCR and matched pairs with axillary pN- without NAC had comparable outcomes. This information will be useful when considering the intensity of follow-up and adjuvant therapy. View Full-Text

Keywords: breast cancer; neoadjuvant chemotherapy; axillary lymph node; pathological complete response; prognosis

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MDPI and ACS Style

Inari, H.; Teruya, N.; Kishi, M.; Horii, R.; Akiyama, F.; Takahashi, S.; Ito, Y.; Ueno, T.; Iwase, T.; Ohno, S. Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy. Cancers 2020, 12, 2633. https://doi.org/10.3390/cancers12092633

AMA Style

Inari H, Teruya N, Kishi M, Horii R, Akiyama F, Takahashi S, Ito Y, Ueno T, Iwase T, Ohno S. Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy. Cancers. 2020; 12(9):2633. https://doi.org/10.3390/cancers12092633

Chicago/Turabian Style

Inari, Hitoshi, Natsuki Teruya, Miki Kishi, Rie Horii, Futoshi Akiyama, Shunji Takahashi, Yoshinori Ito, Takayuki Ueno, Takuji Iwase, and Shinji Ohno. 2020. "Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy" Cancers 12, no. 9: 2633. https://doi.org/10.3390/cancers12092633

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Survival in Cytologically Proven Node-Positive Breast Cancer Patients with Nodal Pathological Complete Response after Neoadjuvant Chemotherapy

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