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Pathologic response to short intensified taxane-free neoadjuvant chemotherapy in patients with highly proliferative operable breast cancer.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2012 Jun; Vol. 35 (3), pp. 242-6. - Publication Year :
- 2012
-
Abstract
- Objectives: Breast cancer treatment relies on 3 major phenotypical subtypes, including the triple-negative (TN), HER2-positive, and hormone receptor-positive (estrogen receptor/progesterone receptor) ones. We retrospectively determined the clinical and pathologic response rates to intensified taxane-free neoadjuvant chemotherapy according to these phenotypical classes in a series of patients with highly proliferative operable breast cancer, and examined the patterns of recurrence.<br />Methods: Patients with early breast cancer with highly proliferative (S-phase fraction >4%) operable tumors of >3 cm received 4 cycles of intensified neoadjuvant chemotherapy with high-dose cyclophosphamide (doxorubicin 70 mg/m d1, cyclophosphamide 700 mg/m d1/d8, and 5 FU 700 mg/m d1-d5) every 3 weeks.<br />Results: Fifty-five patients were included in the analysis. Patients with TN phenotype experienced a high pathologic complete response (pCR) rate to intensified chemotherapy in comparison with patients with HER2-positive and estrogen receptor/progesterone receptor tumors (47%, 0%, and 12%, respectively). Forty percent of patients with TN breast cancer recurred after a median follow-up of nearly 11 years, but only 22% of those achieving a pCR.<br />Conclusions: A high pCR rate to short intensified neoadjuvant chemotherapy with high-dose cyclophosphamide was achieved in patients with operable highly proliferative TN breast cancer, and pCR was associated with a low rate of recurrence.
- Subjects :
- Adult
Breast Neoplasms drug therapy
Breast Neoplasms surgery
Carcinoma, Ductal, Breast drug therapy
Carcinoma, Ductal, Breast surgery
Carcinoma, Lobular drug therapy
Carcinoma, Lobular surgery
Cyclophosphamide administration & dosage
Doxorubicin administration & dosage
Female
Fluorouracil administration & dosage
Follow-Up Studies
Humans
Middle Aged
Neoplasm Recurrence, Local drug therapy
Neoplasm Recurrence, Local surgery
Neoplasm Staging
Prognosis
Receptor, ErbB-2 metabolism
Receptors, Estrogen metabolism
Receptors, Progesterone metabolism
Retrospective Studies
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms pathology
Carcinoma, Ductal, Breast pathology
Carcinoma, Lobular pathology
Neoadjuvant Therapy
Neoplasm Recurrence, Local pathology
S Phase physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 35
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21358298
- Full Text :
- https://doi.org/10.1097/COC.0b013e318209d34c