Clinical Study Of Neoadjuvant Chemotherapy Efficiency And Prognosis In The Treatment Of Triple Negative Breast Cancer

Objective:Neoadjuvant chemotherapy(NAC) as one of the standard treatment options for locally advanced breast cancer which has been widely used in clinical practice. The pathological remission rate of the patients afterNAC is significantly associated with the prognosis. This study aimed to retrospectively analyze the clinical data of triple negative breast cancer (TNBC) patients with NAC, and to explore the influencing factors and prognostic factors of NAC in TNBC patients., and to find the potential factors influencing the efficiency and prognosis of NAC treatment.Methods:A retrospective review of 54 patients with TNBCwhom carried out NAC. Clinical characteristics and pathologic response of patients were taken into consideration. The information on treatment after surgery, recurrence, metastasis, survival conditions, and so on were followed up by telephone and in department for outpatients. The preoperative patients accepted chemotherapy cycle ranging from 2-14. All 54 patients underwent surgery and completed the prescribed treatment. RECIST1.1 was used to evaluatee chemotherapy efficacy in 54 patients.Doppler ultrasonography, palpation and pathologic measurement were used to evaluate Clinical curative effect. Kaplan-Meier analysis was applied to estimate the survival of the groups according to age, the age of menarche cycle, menopausal status, birth history, family history, body mass index (BMI), clinical stages, postoperative axillary lymph nodes, tumor location,Her2, Ki-67, p53, pathological features of tumor, NAC, and adjuvant treatments strategy. Multivariate analysis was carried out using COX risk regression model. Statistical analysis was performed with Statistical Package for Social Science software (SPSS 22.0).Results:Among the 54 TNBC patients,10 cases of pCR(18.9%),29 cases of PR(53.7%),8 cases of PD(14.8%),7 cases of SD(13.0%),16case of CR(29.6%). The different chemotherapy regimens, the number of chemotherapy cycles, the clinical stages and other factors between the different therapeutic effect groups were not statistically significant. Analyzing the therapeutic efficacy, the expression of p53 wsa statistically significant(p=0.013). Patients with negative expression of p53 had better therapeutic efficacy. The median follow-up time was 19.6 months(8-40 months). The median survival time was 31.33 months. The 1 year overall survival rate (OS) was 100%,2 year OS was 73%. The median disease-free survival time of 54 patients (DFS) was 28.1 months. The 1 year DFS was 88%,2 year DFS was 68%. Patients’ age, the age of menarche cycle, menopausal status, birth history, family history of tumor, BMI, pathological clinical stages, Ki-67, pathological features of tumor,NAC, and adjuvant treatment strategy were not significant for OS and DFS. patients clinical stages (p=0.047) and postoperative axillary lymph nodes status (p=0.048) are significant for OS. Tumor location (p=0.020) andpostoperative axillary lymph nodes status (p=0.018) are significant for DFS.Conclusion:p53 is one of the neoadjuvant chemotherapy efficacy factors in TNBC. patients clinical stages (p=0.047) and positive axillary lymph nodes (p=0.048) relate to OS. Positive axillary lymph nodes (p=0.018) is closely related to DFS. COX multivariate analysis, patients with axillary lymph node status is an independent prognostic factor in patients with DFS and OS.