Pandya Jayashri, Joshi Shashank A, Barot Harsh J
General Surgery, Topiwala National Medical College & Bai Yamunabai Laxman (BYL) Nair Charitable Hospital, Mumbai, IND.
Cureus. 2025 Jul 9;17(7):e87579. doi: 10.7759/cureus.87579. eCollection 2025 Jul.
Background Neoadjuvant chemotherapy (NACT) is a key treatment strategy for locally advanced or high-risk early-stage breast cancer. This study aims to evaluate the effects of NACT on estrogen receptor (ER), progesterone receptor (PR), HER2 status, and Ki67 index, which are crucial markers for breast cancer prognosis and treatment decisions. Methods A cohort of 62 female breast cancer patients underwent NACT with varied regimens. Baseline and post-treatment data on ER, PR, HER2 status, and Ki67 were collected through immunohistochemistry and sonomammography. Statistical analysis was performed using R software, with Wilcoxon rank-sum and paired t-tests for primary and secondary outcomes, respectively. Results Significant changes were observed in receptor statuses post-NACT. Notably, 8.3% of ER-negative patients converted to ER-positive, 14.2% of PR-negative patients became PR-positive, and 16.6% of HER2-negative patients became HER2-positive. Ki67 levels decreased significantly from 51.7% to 26.28% (p < 0.001), indicating reduced tumor proliferation. Discussion The shifts in ER, PR, and HER2 status suggest the dynamic nature of breast cancer during chemotherapy, with implications for personalized treatment strategies. The reduction in Ki67 indicates a favorable tumor response, though tumor heterogeneity and treatment resistance remain challenges. These findings underscore the importance of post-treatment molecular profiling to guide therapy decisions and optimize patient outcomes. Conclusion NACT significantly alters the molecular profile of breast cancer, including receptor status and Ki67 levels, which can inform personalized treatment strategies. These findings highlight the need for post-NACT reassessment to tailor follow-up therapies and improve long-term patient outcomes.
背景 新辅助化疗(NACT)是局部晚期或高危早期乳腺癌的关键治疗策略。本研究旨在评估NACT对雌激素受体(ER)、孕激素受体(PR)、HER2状态和Ki67指数的影响,这些是乳腺癌预后和治疗决策的关键标志物。方法 一组62例女性乳腺癌患者接受了不同方案的NACT。通过免疫组织化学和乳腺超声收集ER、PR、HER2状态和Ki67的基线及治疗后数据。使用R软件进行统计分析,分别对主要和次要结局进行Wilcoxon秩和检验和配对t检验。结果 NACT后受体状态出现显著变化。值得注意的是,8.3%的ER阴性患者转为ER阳性,14.2%的PR阴性患者变为PR阳性,16.6%的HER2阴性患者变为HER2阳性。Ki67水平从51.7%显著降至26.28%(p<0.001),表明肿瘤增殖减少。讨论 ER、PR和HER2状态的变化表明化疗期间乳腺癌的动态性质,对个性化治疗策略具有影响。Ki67的降低表明肿瘤反应良好,尽管肿瘤异质性和治疗耐药性仍然是挑战。这些发现强调了治疗后分子谱分析对指导治疗决策和优化患者结局的重要性。结论 NACT显著改变乳腺癌的分子谱,包括受体状态和Ki67水平,可为个性化治疗策略提供依据。这些发现突出了NACT后重新评估以定制后续治疗并改善患者长期结局的必要性。