Ⅰ-Ⅱ Phase HER2 Positive Breast Cancer Neoadjuvant Therapy Efficacy And The Related Clinical Pathologic Factors Of Prospective Studies

Breast cancer is the most common women malignant tumor in the word, and the research about breast cancer has gone into the era of molecular classification. There is a huge difference in the treatment and prognosis of different types of breast cancer. Human epidermal growth factor receptor 2 mutations induced positive HER2 breast cancer. The biological behavior and prognosis of positive HER2 early breast cancer is also poor. New study shows that p CR can improve the prognosis of positive HER2 breast cancer, and joint Trastuzumad neoadjuvant therapy can get the higher p CR rate. Neoadjuvant chemotherapy is the treatment standard of locally advanced breast cancer, but there are few reports of early breast cancer’s neoadjuvant chemotherapy.Therefore, this study collected Ⅰ-Ⅱ phase HER2 positive breast cancer patients who received neoadjuvant therapy, to expole clinical effects of Ⅰ-Ⅱ phase HER2 positive breast cancer by TCH neoadjuvant therapy, comparison and analysis the clinical pathologic factors effect on the rate of p CR.Objective: To expole clinical effects of Ⅰ-Ⅱ phase HER2 positive breast cancer by TCH neoadjuvant therapy, comparison and analysis the clinical pathologic factors effect on the rate of p CR.Methods: In the period from 2009 to 2010, forty eight patients with Ⅰ-Ⅱ phase HER2positive breast cancer received TCH neoadjuvant therapy, then they received a prospective and one-armed neoadjuvant therapy research. The efficacy of treatment was evaluated by breast ultrasound every two cycles. Before receiving neoadjuvant treatment, all patients were received breast MRI. The patients who has been received the two treatment cycles were received breast MRI, and breast MRI was also given to the patients before operation. After two treatment cycles, if the result was invalid, and then these patients might be received surgery; if the result was effective(CR + PR [1])and then these patients would complete 6 cycle neoadjuvant therapy, then they received surgery. According to NCCN guidelines, these patients would be received normal adjuvant therapy after surgery. Follow-up time was five years. Assess the p CR rate, analysis the clinical pathologic factors effect on the rate of p CR, observe the disease-free survival(diseases- free survival, DFS) and Overall survival(Overall survival, OS).Results: The p CR rate of HER2 positive early breast cancer was 66.7% by TCH neoadjuvant therapy; the p CR rates were significantly different in the different levels of HER2 gene amplification(P=0.015); the p CR rates were significantly different in the ER/PR different states(P=0.009); the p CR rates showed no significant difference in the age, tumor size, histological grading and lymph node status(P>0.05);The five years DFS of no- p CR and p CR group were 62.5% and 87.5%,and the five years OS of no-p CR and p CR group were 81.3% and 96.9%.Conclusion: 1.Ⅰ-Ⅱ phase HER2 positive breast cancer by neoadjuvant therapy can get higher rates of p CR. 2. The different levels of HER2 gene amplification may lead to the difference of the p CR rates. 3. p CR can improve DFS(P=0.032) and OS(P=0.035) of Ⅰ-Ⅱphase HER2 positive breast cancer. 4. TCH neoadjuvant therapy for Ⅰ-Ⅱ phase HER2 positive breast cancer issecurity and efficient.