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• W4366277597 abstract "To retrospectively assess the rate of pathologic complete response in the axilla according to breast cancer biologic subtypes, and to study the impact of nodal response on survival. Inclusion criteria were all T-stage breast cancers with initial lymph node involvement, non-metastatic, treated with neoadjuvant chemotherapy followed by surgery with axillary lymph node dissection, managed at the George-François Leclerc Cancer Center in Dijon, France, between 2000 and 2018. Among 437 patients included, the rate of complete nodal response rate varied according to tumor subtypes: 69.4% in Hormone Receptors (HR)-/HER2-positive, 47.4% in HR-/HER2-negative, 46.7% in HR+/HER2-positive, 8.5% in HR+/HER2-negative. By multivariate analysis, the factors significantly associated with complete nodal response were HER2-positive profile (OR 4.48 [2.14–9.65], P < 0.001 if HR+; OR 8.02 [3.54–18.74], P < 0.001 if HR–), triple negative tumors (OR 3.01 [1.40–6.58], P = 0.005), SBRIII grade (OR 6.85 [2.28–29.58], P = 0.002) and breast complete response (OR 18.69 [9.67–38.53], P < 0.001). Five-year recurrence rates were 15.7% in ypN0, 23% in ypN1, 41.2% in ypN2, 50% in ypN3 patients (P < 0.001). Five-year overall survival rates were 92.2% in ypN0, 85.7% in ypN1, 72.2% in ypN2, 65.4% in ypN3 patients (P < 0.001). The impact of nodal response on survival was significant. Pathologic complete response in the axilla appears to be a good surrogate marker of long-term outcome in patients treated for these cancers. Évaluer de façon rétrospective le taux de réponse histologique complète axillaire selon la classification moléculaire des cancers du sein et étudier l’impact sur la survie de la réponse histologique axillaire. Il s’agissait d’une étude monocentrique chez des patientes traitées entre 2000 et 2018 au Centre Georges-François Leclerc à Dijon. Les critères d’inclusion étaient : cancer du sein non métastatique de tous stades T avec envahissement ganglionnaire initial, traité par chimiothérapie néoadjuvante puis chirurgie avec curage axillaire. Parmi les 437 patientes, le taux de réponse axillaire complète variait significativement selon la classification moléculaire : 69,4 % des récepteurs hormonaux (RH) -/HER2-positifs, 47,4 % des triples négatifs, 46,7 % des RH+/HER2-positifs, et 8,5 % des RH+/HER2-negatifs. En analyse multivariée, les facteurs significativement associés à la réponse axillaire étaient : le profil HER2 (OR 4,48 [2,14–9,65], p < 0.001 si RH+ ; OR 8,02 [3,54–18,74], p < 0,001 si RH–),les tumeurs triple négatives (OR 3,01 [1,40–6,58], p = 0,005), le grade SBR III (OR 6,85 [2,28–29,58], p = 0,002) et la pCR mammaire (OR 18,69 [9,67–38,53], p < 0,001). Le taux de récidive à cinq ans était de 15,7 % si ypN0, 23 % si ypN1, 41,2 % si ypN2, 50 % si ypN3 (p < 0,001). Les taux de survie globale à cinq ans étaient de 92,2 % si ypN0, 85,7 % si ypN1, 72,2 % si ypN2, 65,4 % si ypN3 (p < 0,001). L’impact de la réponse axillaire sur la survie s’avère déterminant. La réponse histologique axillaire semble un excellent surrogate marker du devenir à long terme des patientes traitées pour ces cancers." @default.
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• W4366277597 date "2023-06-01" @default.
• W4366277597 modified "2023-10-01" @default.
• W4366277597 title "Axillary pathologic response after neoadjuvant chemotherapy and surgery according to breast cancers subtypes and survival impact" @default.
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• W4366277597 doi "https://doi.org/10.1016/j.bulcan.2023.03.009" @default.
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