Prognostic Impact of Residual Disease After Neoadjuvant Chemotherapy in 648 Patients with Triple-negative Breast Cancer.
AIM
In order to establish a new risk categorization system for triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy, we analyzed a large database including more than 50% of all breast cancer cases nationwide.


PATIENTS AND METHODS
From a database of 39,570 primary breast cancer cases, 648 patients with TNBC were treated with neoadjuvant chemotherapy (2009-2011). The primary study end-point was the impact of residual tumor burden on survival.


RESULTS
Pathological complete response (pCR) was achieved in 199 patients; 449 patients had a non-pCR (pCR rate=30.8%). Stage ypT1 did not differ prognostically from ypT2, and likewise ypT3 not from ypT4 (in patients with N0 and N1-3 disease). Combined analysis of ypT1/2 and ypT3/4 yielded highly significant differences (p=0.000145).


CONCLUSION
A partial response still conveys a substantial survival benefit. There is no linear deterioration of prognosis according to residual tumor size. Post-neoadjuvant TNM stages ypT1 and ypT2, and ypT3 and ypT4 pairwise build uniform prognostic groups in TNBC, when there is no or low axillary lymph-node involvement.
['Kern|Peter|P|', 'Von Minckwitz|Gunter|G|', 'Puetter|Carolin|C|', 'Pavlidou|Sofia|S|', 'Flach|Annika|A|', 'Kimmig|Rainer|R|', 'Rezai|Mahdi|M|']
D000971:Antineoplastic Combined Chemotherapy Protocols D002986:Clinical Trials as Topic D016208:Databases, Factual D005260:Female D006801:Humans D020360:Neoadjuvant Therapy D009367:Neoplasm Staging D018365:Neoplasm, Residual D011446:Prospective Studies D016019:Survival Analysis D064726:Triple Negative Breast Neoplasms
prognostic impact residual disease neoadjuvant chemotherapy Triple-negative breast cancer pathological complete response pCR