Department of Medical Oncology, Georges-François Leclerc Cancer Center, Dijon, France.
Breast. 2013 Jun;22(3):301-8. doi: 10.1016/j.breast.2012.07.012. Epub 2012 Aug 3.
HER2-positive and triple-negative breast cancer (TNBC) still have a poor prognosis. Pathological complete response (pCR) is usually considered a surrogate marker for outcome. The aim of this study was to reconsider these parameters on a large population after a long follow-up. 348 patients with unilateral breast cancer who received neoadjuvant treatment at our institution over 30 years were included.
Patients were classified according to hormonal receptors (HR) and HER2. Median follow-up was 7 years. pCR was significantly lower in HR+/HER2- tumors (P < 0.0001). The 7-year OS rates were 76.1% (HR+/HER2-), 60.1% (TNBC), 72.4% (HR+/HER2+), and 49.9% (HR-/HER2+). Disease-free survival (DFS) and OS differed significantly according to pCR. Among HER2+ patients, pCR rate, DFS and OS were greater with trastuzumab.
TNBC and HR-/HER2+ tumors have the worst outcome. pCR remains a significant prognostic factor. Trastuzumab strongly improves pCR and survival in HER2+ tumors.
HER2 阳性和三阴性乳腺癌（TNBC）的预后仍然较差。病理完全缓解（pCR）通常被认为是预后的替代标志物。本研究的目的是在经过长时间随访后，在大人群中重新考虑这些参数。
共纳入 348 例在我院接受新辅助治疗的单侧乳腺癌患者，随访时间超过 30 年。
患者根据激素受体（HR）和 HER2 进行分类。中位随访时间为 7 年。HR+/HER2-肿瘤的 pCR 显著降低（P<0.0001）。7 年 OS 率分别为 76.1%（HR+/HER2-）、60.1%（TNBC）、72.4%（HR+/HER2+）和 49.9%（HR-/HER2+）。pCR 显著影响疾病无进展生存期（DFS）和 OS。在 HER2+患者中，曲妥珠单抗治疗可提高 pCR 率、DFS 和 OS。
TNBC 和 HR-/HER2+肿瘤的预后最差。pCR 仍然是一个重要的预后因素。曲妥珠单抗可显著提高 HER2+肿瘤的 pCR 率和生存率。
