![]() ![]() These complete responders were excluded from this prospective observational study due to the lack of residual tumors. RESULTS Patient characteristicsĪ total of 121 of the 544 patients (22.2%) with primary breast cancer who received NCT in our study were considered pathologic complete response (pCR) after NCT. The purpose of our study was to assess the discordance rate of the HR status and the HER2 status in patients with residual tumors after NCT and to evaluate the prognostic significance of multiple changes in these statuses. However, little information is available on the prognostic impact of receptor conversion caused by NCT. ![]() Patients showing a conversion from HR (+) to HR (−) tended to benefit less from NCT compared to those with no change or the opposite conversion. Previous studies have shown that NCT can alter the status of HR and HER2. A core needle biopsy (CNB) is commonly performed to confirm the diagnosis and determine the presence of immunohistochemical (IHC) markers, such as human epidermal growth factor receptor 2 (HER2) and hormone (estrogen and progesterone) receptor (HR), which are key factors in the decision-making process regarding adjuvant therapy as well as important prognostic indicators. Neoadjuvant chemotherapy (NCT) followed by definitive surgical resection is a commonly utilized therapeutic approach for locally advanced breast cancer and is likely to improve the operability of these patients by downstaging their primary tumors. The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome. In conclusion, patients with breast cancer may experience changes in HR status, HER2 status and tumor phenotype after NCT. Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS. The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis. A total of 54 (12.8%) changed to the triple-negative (TN) tumor phenotype. This prospective observational study aimed to evaluate the prognostic impact of receptor conversion in breast cancer patients treated with NCT.Of the 423 consecutive patients who had residual disease in the breast after NCT, 55 (13.0%) changed from HR (+) to HR (−), 23 (5.4%) changed from HR (−) to HR (+), 27 (6.4%) changed from HER2 (+) to HER2 (−), and 13 (3.1%) changed from HER2 (−) to HER2 (+). The hormone receptor (HR) status and human epidermal growth hormone receptor 2 (HER2) status of patients with breast cancer may change following neoadjuvant chemotherapy (NCT). Received: JanuAccepted: FebruPublished: March 16, 2015 Keywords: breast cancer, neoadjuvant chemotherapy, receptor conversion, prognosis *These authors have contributed equally to this work Xi Jin 1, *, Yi-Zhou Jiang 1, *, Sheng Chen 1, *, Ke-Da Yu 1, Zhi-Ming Shao 1, Gen-Hong Di 1ġDepartment of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ![]()
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