Predictive Factors of Neoadjuvant Chemotherapy Response in Breast Cancer Validated by Three Anatomopathological Scores: Residual Cancer Burden, Chevallier System, and Tumor-Infiltrating Lymphocytes.

Autor:	Popa CN; Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila', Bucharest, ROU.; Department of General Surgery I, 'Sf. Maria' Clinical Hospital, Bucharest, ROU., Bîrlă R; Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila', Bucharest, ROU.; Department of General Surgery I, 'Sf. Maria' Clinical Hospital, Bucharest, ROU., Daniela D; Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila', Bucharest, ROU.; Department of General Surgery I, 'Sf. Maria' Clinical Hospital, Bucharest, ROU., Iosif C; Department of Pathology, 'Sf. Maria' Clinical Hospital, Bucharest, ROU., Chirita E; Department of Oncology, 'Sf. Maria' Clinical Hospital, Bucharest, ROU., Mateș IN; Faculty of Medicine, University of Medicine and Pharmacy 'Carol Davila', Bucharest, ROU.; Department of General Surgery I, 'Sf. Maria' Clinical Hospital, Bucharest, ROU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Apr 30; Vol. 16 (4), pp. e59391. Date of Electronic Publication: 2024 Apr 30 (Print Publication: 2024).
DOI:	10.7759/cureus.59391
Abstrakt:	Introduction: The aim of this retrospective, observational, descriptive study was to identify predictors of response to neoadjuvant therapy in breast cancer patients and to validate them using three anatomopathological scores, such as residual cancer burden (RCB) score, Chevallier system, and tumor-infiltrating lymphocytes (TIL) score. Materials and Methods: We conducted a study on 88 female patients aged 37 to 78 years with confirmed breast cancer who were indicated for neoadjuvant chemotherapy. We analyzed different individual variables (such as age, menarche, and menopause), clinical/imaging characteristics of the breast tumor and axillary nodes, immunohistochemical biomarkers (such as ER/PR/HER2 and Ki67), and histopathological features (such as subtype and grading) in relation to three anatomopathological scores calculated based on the surgical resection specimen. Results: The percentage of patients who could have benefited from conservative surgery increased from 6% at the time of diagnosis to 20% post-primary systemic therapy (PST). Age under 49 (p = 0.01), premenopausal status (p < 0.01), no special type (NST) (p = 0.04), high Ki67 (p < 0.01), triple-negative breast cancer (TNBC) (p = 0.02) are positive predictive factors of neoadjuvant therapy, while lobular/mixt carcinoma-type (p = 0.04), luminal A (p = 0.01), positive lymph node (p < 0.01), and low differentiation grade (p = 0.01) are negative predictive factors for the response to PST. Conclusion: There is a strong correlation between the RCB score and the Chevallier system for quantifying the response to PST, with most predictive factors being confirmed through appropriate statistical analysis for both. TIL score values correlated with only some of the predictors, most likely due to the importance of calculating this score on both biopsy specimens at diagnosis and resection specimens after chemotherapy. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Popa et al.)
Databáze:	MEDLINE
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