Atoui Ali, Bou Zerdan Maroun, El Mahmoud Ahmad, Chamseddine Nathalie, Hamad Lina, Assi Hazem I
Department of Internal Medicine, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon.
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Int J Breast Cancer. 2022 Feb 12;2022:1218128. doi: 10.1155/2022/1218128. eCollection 2022.
Breast cancer is considered nowadays the most prevalent cancer worldwide. The molecular era has successfully divided breast cancer into subtypes based on the various hormonal receptors. These molecular subtypes play a major role in determining the neoadjuvant chemotherapy to be administered. It was noted that the use of neoadjuvant chemotherapy was associated with higher achievement of pathological complete response. The aim of the study was to determine the predictive role of breast cancer subtypes in the efficacy and prognosis of neoadjuvant chemotherapy regimens.
Combining dose dense anthracycline-based, regular dose anthracycline-based, and nonanthracycline-based chemotherapy, we observed data from 87 patients with breast cancer who received surgery after administration of neoadjuvant chemotherapy at our institution between January 2015 and July 2018. The patients were classified into luminal A, luminal B, HER2 overexpression, and triple negative breast cancer as well as low Ki67 (≤14%) and high Ki67 (>14%) expression groups using immunohistochemistry. Pathologic complete response was the only neoadjuvant chemotherapy outcome parameter. To evaluate variables associated with pathologic complete response, we used univariate analyses followed by multivariate logistic regression.
87 patients with breast cancer were classified into different subtypes according to the 12 St. Gallen International Breast Cancer Conference. The response rate to neoadjuvant chemotherapy was significantly different ( = 0.046) between the subgroups. There were significant correlations between pathological complete response (pCR) and ER status ( < 0.0001), HER2 ( = 0.013), molecular subtypes ( = 0.018), T stage ( = 0.024), N stage before chemotherapy ( = 0.04), and type of chemotherapy ( = 0.029). Luminal B type patients had the lowest pCR, followed by luminal A type patients.
Evaluating molecular subtype's significance in breast cancer prognosis warrants additional studies in our region with extensive data about patient-specific neoadjuvant chemotherapy regimens. Our study was able to reproduce results complementary to those present in the literature in other outcomes.
如今，乳腺癌被认为是全球最常见的癌症。分子时代已成功地根据各种激素受体将乳腺癌分为不同亚型。这些分子亚型在确定要实施的新辅助化疗方面起着主要作用。值得注意的是，新辅助化疗的使用与更高的病理完全缓解率相关。本研究的目的是确定乳腺癌亚型在新辅助化疗方案的疗效和预后中的预测作用。
结合基于剂量密集蒽环类、常规剂量蒽环类和非蒽环类化疗，我们观察了2015年1月至2018年7月期间在我院接受新辅助化疗后接受手术的87例乳腺癌患者的数据。使用免疫组织化学将患者分为腔面A型、腔面B型、HER2过表达型和三阴性乳腺癌以及低Ki67（≤14%）和高Ki67（>14%）表达组。病理完全缓解是唯一的新辅助化疗结果参数。为了评估与病理完全缓解相关的变量，我们先进行单因素分析，然后进行多因素逻辑回归。
根据第12届圣加仑国际乳腺癌会议，87例乳腺癌患者被分为不同亚型。各亚组对新辅助化疗的反应率有显著差异（P = 0.046）。病理完全缓解（pCR）与雌激素受体状态（P < 0.0001）、HER2（P = 0.013）、分子亚型（P = 0.018）、T分期（P = 0.024）、化疗前N分期（P = 0.04）和化疗类型（P = 0.029）之间存在显著相关性。腔面B型患者的pCR最低，其次是腔面A型患者。
评估分子亚型在乳腺癌预后中的意义需要在我们地区进行更多研究，以获取有关患者特异性新辅助化疗方案的广泛数据。我们的研究能够重现与文献中其他结果互补的结果。
