Predictors Of Pathological Complete Response And Changes In The Immunohistochemical Biomarkers Status After Neoadjuvant Chemotherapy For Breast Cancer

Objective: The aim of the current study was to identify predictors ofpCR and to evaluate the changes in the immunohistochemical(IHC)biomarkers after NAC （Docetaxel+Epirubicin/Pirarubicin+Cyclophosphamide）.Methods: From01/01/2012to31/12/2012,257patients treated withNAC were included in this retrospective study．Data were compared usingchi-square、Fisher’s exact tests、likelyhood ratio or multivariate analysis ofvariance, et al, as appropriate.Results: Of257breast cancer patients receiving NAC,42(16.3%)gained pCR. Five factors were associated with pCR: tumor grade T1(P=0.006), ER negative (P<0.001), PR negative (P=0.013,),Ki67(proliferation scores>30%, P=0.004,) and giving birth to one child(P=0.032). On multivariate analysis, DNBC（OR=7.248,95%CI=2.453to21.416）, Ki67(proliferation scores>30%, OR=4.355,95%CI=1.513to 12.537), giving birth to one child（OR=3.926,95%CI=1.040to14.821）were found to significantly correlate with pCR. The highest changing ratesof positive to negative and negative to positive is respectively Ki67(37.5%)and P53(13.3%), the lowest changing rates of positive to negative andnegative to positive is respectively ER(16.1%), P53(16.1%) andKi67(2.7%). A significant change was only observed for Ki67proliferativefraction (28.6%vs.19.7%，P<0.001). Significant changes of Ki67(P=0.012)and P53(P=0.005) from positive to negative are observed forpatients no younger than50years old, and significant change of ER fromnegative to positive is observed for blood type A (P=0.006)and O(P=0.006)patients.Conclusion: DNBC, Ki67(proliferation scores>30%), giving birth toone child are more likely to experience pCR to NAC. Childbearing historyis newly identified as an important predictor. NAC suppress breast cancergrowth partially by suppressing Ki67proliferation. No significant changesare observed in ER, PR and P53status. Characteristics such as age, bloodtype, lymphnode, et al, are significant factors for the changes of biomarkersafter NAC.