Abstract 180P
Background
Neoadjuvant treatment is becoming established in early breast cancer due to its impact in overall survival. Although it is the Her2 and triple-negative phenotypes where the greatest impact has been seen, the luminal has also seen it, so it is interesting to find the patterns of recurrence after neoadjuvant treatment.
Methods
624 patients with early breast cancer treated with neoadjuvant therapy (2004-2018) were analyzed to determine factors associated with relapse.
Results
Median age was 55 (28-89), median tumor size 38 mm (12-100), 325 (50%) had nodal involvement, phenotypes according to immunohistochemistry were: luminal 224 (35%) HER2+ 227 (35%) and triple-negative 191 (30%). With median follow-up of 72 months (4-331) a total of 32% of pathologic complete response (pCR) was detected and 26% relapsed. We found a significant association in relapse in the global series for pCR (OR 0.245, p=0.000), tumor size (OR 1.01, p=0.000) and nodal involvement (OR 2.431, p=0.000). The pCR and recurrence according to subtypes is represented in the table, luminal with pCR is the group with least recurrence (4,5%) and HER2 + non luminal and triple-negative without pCR is the group with most recurrence (46%). Table: 180P
| Luminal | HER2+Luminal | HER2+ No luminal | Triple-negative | Total | |
| pCR | 9.8% | 34.1% | 58.7% | 42.9% | 32.0% |
| Rec in pCR | 4.5% | 7.1% | 18.0% | 9.8% | 11.1% |
| Rec in non pCR | 30,0% | 18.0% | 46,0% | 45.9% | 33.8% |
The median disease-free survival (DFS) and overall survival (OS) was 242 and 240 months for the global series. pCR was associated with better DFS and OS (Cox model: HR 0,30 p:0.000 and HR 0,32 p:0.000) than non pCR and was more significant associated with less recurrence or death in triple-negative (Cox model: HR 0.16 p:0.000) and less significant in HER2 + luminal ( Cox model: HR 0.39 p:0.14 and HR 0.81 p:0.764).
Conclusions
pCR is the most robust factor associated with better survival with only a 11% of relapse. All subtypes benefited from pCR except the HER2 luminal, with a recurrence rate of only 14%. Achieving a pCR has a great impact on survival, specially in the HER2 + and triple-negative. The luminal subtype, despite only achieving 9% of pCR, also has an impact on survival with only 4.5% relapses compared to 30% in those who fail to achieve a pCR.
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.