The Assessment Of Efficacy And Factors Related With Pathological Complete Response Of Neoadjuvant Chemotherapy In Breast Cancer

Objective To assess the response of neoadjuvant chemotherapy by clinical and pathological evaluation and investigate the difference between them in breast cancer patients. To explore the factors related with pathological complete response and whether molecular subtypes of breast cancer was able to predict pathological complete response after neoadjuvant chemotherapy.Method 197 patients with stage Ⅱor stage Ⅲ breast cancer who were treated with neoadjuvant chemotherapy in Ningxia Medical University General Hospital Cancer Hospital were included in this retrospective study. Response of neoadjuvant chemotherapy were evaluated by clinical examination,breast ultrasonography and pathological methods.Using univariate analysis and multivariate Logistic regression analysis factors to obtain pCR after neoadjuvant chemotherapy.Result Complete response and clinical objective response rate determined by clinical examination(cCR,cOR), breast ultrasonography(sCR,sOR),cCR combine with sCR and pathology(pCR)was15.2% and 77.7%;11.7% and 77.2%;4.1%;16.2%,respectively.The correspondence rate of the pCR with cCR、 sCR 、cCR combine with sCR was 36.7%、39.1% and 87.5%,respectively. Consistency Check kappa values were 0.24、0.22 and 0.31.Univariate analysis showed that:Influence factors,such as clinical tumor stage,lymph node metastasis,ER and PR status,chemotherapy cycles. The different molecular subtypes have different pCR rate(P<0.05), triple negative breast cancer(34.4%)>HER-2 over-expressing(17.6%)>LuminalB(14.7%) >LuminalA(3.1%). Multivariate analysis showed that:clinical tumor stage、ER status and chemotherapy cycles was an independent predictive factor for pCR to neoadjuvant chemotherapy.Conclusions Simple breast examination and breast ultrasonography can not be an independent predictor of response of neoadjuvant chemotherapy. Clinical examination combine with breast ultrasonography have better value than separate evaluation in the evaluation of neoadjuvant chemotherapy. The different molecular subtypes have different pCR rate, pCR was more frequently observed in triple negative breast cancer than LuminalA. Clinical tumor stage,ER status and chemotherapy cycles was an independent predictive factor for pCR to neoadjuvant chemotherapy.