Impact of Pathological Complete Response in Breast Cancer Following Neoadjuvant Therapy on Patient’s Outcome

Abstract

Background: Patients who achieve a pathological complete response (pCR) after neoadjuvant therapy have better outcomes than patients with residual disease. Despite the excellent prognosis associated with achieving a pCR, recurrence still occurs. The study was conducted with the intent to evaluate factors associated with tumor recurrence and survival among patients achieving pCR after neoadjuvant therapy.

Methods: We evaluated the medical records of patients with breast cancer who received neoadjuvant therapy and achieved pCR in our academic institute. The survival curve was estimated with the Kaplan-Meier method in patients who developed recurrence.

Results: In our retrospective study 2,360 received neoadjuvant therapy out of which 315 (13.3%) who achieved pCR were included in this study. The mean age was 45.85 (range 21-92 years) and the mean duration of follow-up was 41.2 months. The clinical tumor stage T1-T2 represented 55%, T3-T4 was 44.1%, and node-positive was 54%. The primary endpoint was the correlation between pCR achieved after neoadjuvant therapy and disease-free survival or overall survival. . Predictors of pCR were clinical T-stage and receiving appropriate chemotherapy. We observed that patients who had an increased risk of recurrence after achieving pCR were those with clinical stage III-IV, patients with mastectomy, and those with triple-negative tumor subtype.

Conclusion: Achieving pCR after neoadjuvant therapy is distinctly related to the improvement of survival, however patients who achieved a pCR, women younger than 50 years of age and those with stage III/IV disease have a higher risk of developing distant metastasis.