Analysis of influencing factors of pathological complete response in breast and armpit after neoadjuvant therapy for breast cancer
Objective To explore the influencing factors of pathological complete response(pCR)in breast and armpit after neoadjuvant therapy(NAT)for breast cancer,so as to provide some reference for the feasibility of axillary surgical de-escalation after NAT.Methods According to the inclusion and exclusion criteria,the data of breast cancer patients who had received NAT admitted to the China-Japan Union Hospital of Jilin University from 2015 to the present were retrospectively analyzed.All the patients enrolled were diagnosed with breast cancer with ipsilateral axillary lymph node metastasis,and all of them underwent modified radical mastectomy after receiving standard NAT.The relevant indexes of patients were collected,and the factors affecting pCR in breast and armpit were analyzed by Χ² test and multivariate logistic regression.The feasibility of axillary surgical de-escalation under pCR guidance after NAT was discussed.Results A total of 110 eligible patients were included in this study,including 42 cases(38.2%)with breast pCR,59 cases(53.6%)with axillary pCR,and 37 cases(33.6%)with overall pCR.Univariate analysis showed that N stage,estrogen receptor(ER),human epidermal growth factor receptor-2(HER2),Ki67,molecular type and neoadjuvant regimen were associated with breast pCR(P<0.05),while ER,progesterone receptor(PR),HER2,molecular type,neoadjuvant regimen,and breast pCR were associated with axillary pCR(P<0.05).Further multivariate logistic regression analysis showed that patients receiving chemotherapy combined with a dual target regimen were more likely to obtain breast pCR compared with patient receiving a multi-agent chemotherapy regimen(OR=6.957,95%CI=1.124,43.043,P<0.05).Patients who achieved breast pCR were more likely to obtain axillary pCR comapred with those who did no achicved breast pCR(OR=11.954,95%CI=3.475,41.114,P<0.001).Conclusion After NAT,patients who receive chemotherapy combined with a dual-target regimen are more likely to obtain breast pCR,and patients who achieve breast pCR are more likely to achieve axillary pCR.Breast pCR has reference value for axillary surgical de-escalation.
breast cancerneoadjuvant therapypathological complete responsesurgical de-escalation
万方数据
维普
