Abstract:

Objective

To assess the different response between histological and receptor-based subtypes after short intensive neoadjuvant chemotherapy.

Methods

A consecutive series of 223 patients with operable breast cancer treated with short intensive neoadjuvant chemotherapy were analyzed in Breast Diseases Centre of Southwest Hospital between January 2004 to December 2006. Tumors were classified according to their receptor status in estrogen receptor (ER)-positive tumors (HER-2-negative), triple-negative tumors,and HER-2-positive tumors after core-biopsy. All patients received 4 cycles of docetaxel(75 mg/m²d1) plus epirubicin (75m mg/m² d1) every 14 days. Chi-square test was used to analyze the relation of histological and receptor-based subtypes with pathological complete response (pCR) and chemotherapy response rate.

Results

The overall response rate and pCR rate of intensive neoadjuvant chemotherapy was 59% (132 of 223) and 9% (21 of 223),respectively. In patients with ductal and lobular carcinomas the overall response rate was 70%(122 of 175)and 24%(8 of 33)(P＜0.01); and the pCR rate was 11%(20 of 175)and 3%(1 of 33). In ER-positive, triple-negative and HER-2-positive tumors, the overall response rate was 46%(57 of 123), 84%(43 of 51)and 65%(32/49), respectively(χ²=22.49,P=0.00).The pCR rates of ER-positive, triple-negative and HER-2-positive tumors were 2%(3 of 123),23%(12 of 51)and 12%(6 of 49), respectively(χ² =19. 39,P=0. 00).

Conclusions

In lobular tumors the benefit of short intensive neoadjuvant chemotherapy is limited. the pCR rate of ER-positive tumors is low.

Key words: breast neoplasms, neoadjuvant chemotherapy