Evaluation of Neoadjuvant Chemotherapy for Triple Negative Breast Cancer with HER-2-low Expression and HER-2-zero Expression
Objective To investigate the efficacy difference between HER-2-low expression and HER-2-zero expression in neoadjuvant chemotherapy(NAC)of patients with triple negative breast cancer(TNBC).Methods The clinicopathologic data of 120 patients with TNBC treated in Nanyang Central Hospital from January 2018 to January 2020 were retrospectively collected.They were ini-tially treated with NAC,including 57 patients with HER-2-low expression,and 63 patients with HER-2-zero expression.Bilateral χ2 test was used to compare the clinicopathologic features,3-year recurrence rate or metastasis rate of the two groups.The influence of clinicopathologic factors on pathological complete response(pCR)was analyzed by binary Logistic regression analysis.Survival curves were used to compare the disease-free survival rates between the two groups.Results Compared with the HER-2-zero expression group,the proportion of patients with T3-4 stage in the HER-2-low expression group was significantly higher(P<0.05),the propor-tion of patients with axillary lymph node metastasis was also significantly higher(P<0.05),and the histological grade was lower(P<0.05).Axillary lymph node status(P<0.05)and HER-2 expression level(P<0.05)were independent influencing factors for pCR in patientswith TNBC.TNBC patients with axillary lymph node metastasis and HER-2-low expression were less likely to reach pCR status after NAC treatment.In addition,compared with the HER-2-zero expression group,the 3-year recurrence rate or metastasis rate in the HER-2-low expressio group was significantly increased(28.1%vs 11.1%,P<0.05),and the disease-free survival rate was significantly decreased(P<0.05).Conclusion In TNBC patients,compared with HER-2-zero expression,patients with HER-2-low expression had a higher rate of axillary lymph node metastasis,were less likely to achieve pCR after NAC,and had poorer prognosis.
Triple negative breast cancerHER-2-low expressionClinicopathological featuresNeoadjuvant chemotherapyPathological complete response
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