Abstract 2476
Background
Nodal involvement is a common prognostic factor in early breast cancer (EBC) but their response and assessment after neoadjuvant chemotherapy (NAC) is controversial, hence its impact in survival is not clear.
Methods
We analyze a cohort of 308 EBC patients with initial nodal involvement and their response to neoadjuvant chemotherapy and their impact in disease free survival (DFS).
Results
Median age was 52 (range 29-87), median tumor size was 38mm (10-100) and 178 patients (57,8%) had initial palpable node involvement. According to the immunohistochemical expression of hormonal receptors, Ki 67 and HER2; 110 patients (35,7%) was HER2 positive, 119 (38,6%) luminal and 79 (25,6%) triple negative breast cancer. After NAC we found a total of pathological complete response in breast (pCRb) of 30% and pathological complete response in axilla (pCRa) of 45%. Response by different subtypes was: in HER2 a pCRb 41,8% and pCRa 56,3%; luminal a pCRb 13% pCRa 30,3% and triple negative a pCRb 41,8% pCRa 50,6%. Luminal patients achieved the worst axillary response (p:0,004) and without other variables with significant association like tumor initial size or palpable axillary nodes. The global coincidence between pCRb and pCRa was 83% and very similar in the different subtypes. Axillary pCR was associated with a better DFS in the global series (HR: 0,377 p:0,000) but not in the luminal patients (HR:0,455 p:0,072) and the median survival in patients with pCRa was 157 months in contrast to 121 in patients that not achieve a pCRa (153 vs 99 in HER2, 160 vs 141 in luminal and 167 vs 93 in triple negative).
Conclusions
The complete pathological response in axila after neoadjuvant chemotherapy is 45% in our serie but lower in luminal patients with only a 30%. There was a high level of concordance between pCR in breast and axilla in all subtypes with an 83%. Achieving pCR in axilla is associated with better disease free survival but this benefit is lower in luminal phenotype.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1025 - Liver metastases (LM) from intrahepatic cholangiocarcinoma (iCCA): Outcomes from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) registry and implications on current American Joint Committee on Cancer (AJCC) staging.
Presenter: Angela Lamarca
Session: Poster Display session 2
Resources:
Abstract
5813 - Is MGMT methylation a new therapeutic target for Biliary Tract Cancer?
Presenter: Monica Niger
Session: Poster Display session 2
Resources:
Abstract
5839 - Biliary Tract Cancers in Portuguese families with BRCA gene mutation: a retrospective study.
Presenter: Patricia Pereira
Session: Poster Display session 2
Resources:
Abstract
4338 - Selection of patients with hepatocellular carcinoma for selective internal radiation therapy based on tumour burden and liver function: a post-hoc analysis of the SARAH trial
Presenter: Daniel Palmer
Session: Poster Display session 2
Resources:
Abstract
1700 - Second-line chemotherapy (SLC) in Patients with Advanced Biliary tract and Gallbladder Cancers (ABGC) Prolongs Survival: A Retrospective Population-based Cohort Study
Presenter: Adnan Zaidi
Session: Poster Display session 2
Resources:
Abstract
5562 - Overall survival of patients with hepatocellular carcinoma receiving sorafenib versus selective internal radiation therapy with predicted dosimetry in the SARAH trial
Presenter: Neil Hawkins
Session: Poster Display session 2
Resources:
Abstract
1838 - Multicenter phase II trial of axitinib monotherapy for advanced biliary tract cancer refractory to gemcitabine-based chemotherapy
Presenter: Naohiro Okano
Session: Poster Display session 2
Resources:
Abstract
3641 - Soluble Programmed Death-ligand 1 indicate poor prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization
Presenter: Xiaolu Ma
Session: Poster Display session 2
Resources:
Abstract
2733 - The Prognostic Nutritional Index (PNI) is an independent predictor of survival in advanced biliary cancers (ABC) receiving first-line chemotherapy (1L).
Presenter: Francesco Caputo
Session: Poster Display session 2
Resources:
Abstract
3773 - Impact of centralisation of national cancer services on patient outcomes for hepatobiliary cancers in Ireland 2000 – 2016
Presenter: David O Reilly
Session: Poster Display session 2
Resources:
Abstract