Analysis Of Risk Factors For Recurrence And Matastasis In Breast Cancer Patients With A Pathologic Complete Response After Neoadjuvant Chemotherapy

Objective: Recently,pathological complete response has become one of the goal of neoadjuvant chemotherapy(NAC).Studies have found that pathological complete response(p CR)obviously improves the prognosis of the most patients with breast cancer.However,there is still recurrence and metastasis in patients with p CR after neoadjuvant chemotherapy.In this study we have observed the clinical and pathological characteristics of patients with p CR to find out the possible related factors of recurrence and metastasis,and to carry out the appropriate intensive treatment for these patients with high risk factors,so as to further improve the prognosis and achieve more personalized and accurate medicine.Methods: Retrospective analysis was performed on 76 cases of breast cancer with p CR after neoadjuvant chemotherapy in the breast cancer center of the Fourth Hospital of Hebei Medical University from January 2013 to December 2017.Relevant basic clinical information,immunohistochemical results,chemotherapy regimen,surgical methods and postoperative treatment were collected for retrospective analysis.SPSS 22.0 statistical software was used for statistical analysis of the collected data,Kaplan-Meier survival analysis was used for univariate survival analysis and survival curve was drawn,and cox proportional risk regression model was used for multivariate survival analysis.According to the test level,P<0.05 indicates that the difference is statistically significant.Results: From January 2013 to December 2017,76 breast cancer patients received neoadjuvant chemotherapy and obtained p CR in total.The median follow-up time was 45 months(8-81 months),and 7 patients(9.2%)had recurrence and metastasis,including 3 patients with local recurrence and 4 patients with distant metastasis.Single factor analysis shows that there are statistically significant differences between the two groups in age(P=0.005),clinical stage(P=0.014),and the number of lymph nodes dissected(P=0.014).Multivariate analysis shows that age [HR=0.106,95% CI(0.023,0.485),P=0.004]and clinical stage[HR=3.427,95% CI(1.178,9.966),P=0.024]are high risk factors for recurrence and metastasis in p CR patients after neoadjuvant chemotherapy for breast cancer.Age≤35 years old,clinical stages IIIB-IIIC are the risk factors for recurrence and metastasis in breast cancer patients with p CR after neoadjuvant chemotherapy.Conclusions:1.There are still a risk of recurrence and metastasis in breast cancer patients with p CR after neoadjuvant chemotherapy.2.Age≤35 years and clinical stage IIIB and IIIC are the possible related factors for recurrence and metastasis of breast cancer obtain p CR after neoadjuvant chemotherapy.