The Correlation Between Neoadjuvant Chemotherapy And Complete Remission And Disease-free Survival In Breast Cancer Patients With Different Molecular Subtypes

Objective : A retrospective analysis was made of the clinical data of 229 cases of breast cancer treated with neoadjuvant chemotherapy(NAC,Neoadjuvant chemotherapy),which was based on anthracycline and taxanes,admitted to Tumor Hospital Affiliated to Guangxi Medical University.To analyze the correlation of NAC with pathological complete response(pCR)and disease-free survival(DFS)in breast cancer patients with different molecular subtypes,and to observe whether the results of our center are consistent with those of domestic and foreign studies,which can provide reference for the diagnosis and treatment of breast cancer in our region.Method : The clinical data of breast cancer patients receiving NAC from February 2010 to September 2015 in Tumor Hospital Affiliated to Guangxi Medical University were collected.229 patients with breast cancer received NAC based on anthracycline and taxanes and the curative effect was evaluated after operation.According to the molecular subtypes of breast cancer,Luminal A,Luminal B,HER2 overexpression and triple negative breast cancer(TNBC,Triple negative breast cancer)were analyzed.To explore the relationshipbetween pCR and breast cancer of different molecular subtypes,and the relationship between pCR and DFS of breast cancer of different molecular subtypes.Result:Luminal A type accounted for 81 cases(35.4%),Luminal B type 43cases(18.8%),HER2 overexpression 56 cases(24.4%)and TNBC 49 cases(21.4%).The pCR rate was 14.8%(34/229),and the pCR rates of HER2 overexpression and TNBC were 21.4% and 26.5% respectively,which were higher than those of Luminal A(6.2%)and Luminal B(9.3%).Molecular subtypes of breast cancer were independent influencing factors of pCR(P=0.003).Although the pCR rates of HER2 overexpression and TNBC were higher,the DFS of HER2 overexpression and TNBC were worse than those of Luminal A and Luminal B(P < 0.001).On the whole,the DFS of pCR group was higher than that of non-pCR group(P=0.007),and pCR was an independent influencing factor of DFS(P=0.009).Among breast cancer molecular subtypes,DFS of Luminal A and Luminal B reached pCR group was higher than that of non-pCR group,but there was no significant difference(P=0.279,P=0.337).DFS of HER2 overexpression group and TNBC reached pCR group was significantly higher than that of non-pCR group,the difference was statistically significant(P=0.031,P=0.011).Conclusion : Different molecular subtypes of breast cancer patients are based on anthracycline and taxanes.Breast cancer molecular subtypes can predict pCR.HER2 overexpression and TNBC are the most likely to reach pCR,and have a significant correlation with DFS;LuminalA breast cancer patients have a low pCR rate,and there is no significant correlation with DFS.