Outcomes of Invasive Breast Cancer after Neoadjuvant Therapy and Its Association with Molecular Profiles
Jamie Boone, Ossama W Tawfik, Fang Fan. University of Kansas Medical Center, Kansas City, KS
Background: The clinical implications of the molecular profile and response to neoadjuvant chemotherapy (NACT) of invasive breast carcinoma and its association with outcome are still being defined. This study is designed to collect outcome data on breast cancer patients with invasive breast carcinoma treated with neoadjuvant chemotherapy.
Design: We retrospectively identified 84 cases of biopsy proven invasive breast carcinoma treated with NACT from 2007 to 2011 at our medical center. The tumor biomarker profile [including estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (Her2) and Ki-67], pathological response, and patient follow-up data were recorded. Tumor response was divided into complete pathologic response (pCR, no residual invasive tumor identified), partial response (PR, residual invasive cancer identified), and no response (NR, no change in tumor size/cellularity).
Results: Among these 84 cases, 21 had NR, 46 had PR and 17 had pCR. While the majority of tumors with NR (67%) and PR (52%) were ER+/PgR±/Her2-, the majority of tumors with pCR (70%) were ER-/PgR-/Her2-. Ki-67 was not associated with tumor response. With follow-up time of 6-60 months (average 31 months), the NR group had 5 cases of recurrence (average time of 12.6 months before recurrence) and 3 cases of death or hospice enrollment (average time of 19.3 before death/hospice); the PR group had 10 cases of recurrence (average time of 20.7 months before recurrence) and 7 cases of death or hospice enrollment (average time of 32.7 months before death/hospice); and the pCR had no cases of recurrence or death. Cases of recurrence and death did not show a correlation with a specific biomarker profile.
Conclusions: Tumor biomarker profile is a large predictor of response to neoadjuvant chemotherapy. pCR is associated with a better prognosis as compared to PR and NR groups in terms of tumor recurrence and survival. In the PR and NR groups, no specific biomarker profile is identified in association with tumor recurrence or death. Further molecular studies in these groups of patients are necessary to identify additional predictive/prognostic factors.
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 26, Wednesday Morning