Long-term outcomes and risk profile of cT3N0 breast cancer treated with neoadjuvant chemotherapy and curative surgery

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-09-09 DOI:10.1111/1754-9485.13746

Young Seob Shin, Jae Ho Jeong, Il Yong Chung, Jaeha Lee, Su Ssan Kim, Seung Do Ahn, Jong Won Lee, Byung Ho Son, Jinhong Jung

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引用次数: 0

Abstract

Introduction

We evaluated the treatment outcomes and failure patterns in cT3N0 breast cancer patients classified for rigorous pretreatment evaluation and treated with neoadjuvant chemotherapy (NAC) and curative surgery.

Methods

We reviewed the records of 87 cT3N0 breast cancer patients who received NAC and curative surgery between 2000 and 2015. The clinical high-risk group was defined as having two or more risk factors: age < 40, histologic grade 3, lymphovascular invasion, hormone receptor negativity, and Ki-67 labeling index >20%.

Results

Of the patients, 84 (96.6%) and 79 (90.8%) were initially evaluated using magnetic resonance imaging and positron emission tomography/computed tomography. Most patients received anthracycline based NAC regimen (n = 69, 79.3%) and modified radical mastectomy (n = 61, 70.1%). During a 91.5-month median follow-up, ten patients experienced distant metastasis (DM) only, two had isolated local recurrence, one had local recurrence and DM, and another had local recurrence, regional recurrence, and DM. The 5-year rates of locoregional recurrence, DM, any recurrence (AR), and overall survival (OS) were 1.2%, 11.6%, 11.6%, and 90.8%, respectively. The risk group was an independent prognostic factor of recurrence, and the high-risk group had worse rates of DM (19.2% vs. 0%, P = 0.009), AR (19.2% vs. 0%, P = 0.016) and OS (82.8% vs. 100%, P = 0.001).

Conclusion

Patients with cT3N0 breast cancer classified for rigorous pretreatment evaluation and treated with NAC and radical surgery had favourable oncological outcomes. A clinical risk group based on clinical and immunohistochemical risk factors was an excellent predictor of survival and recurrence.

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采用新辅助化疗和根治性手术治疗 cT3N0 乳腺癌的长期疗效和风险概况

方法我们回顾了2000年至2015年间接受新辅助化疗（NAC）和根治性手术治疗的87例cT3N0乳腺癌患者的病历。临床高危组被定义为具有两个或两个以上风险因素：年龄< 40岁、组织学分级3级、淋巴管侵犯、激素受体阴性和Ki-67标记指数>20%。结果在患者中，84人（96.6%）和79人（90.8%）通过磁共振成像和正电子发射断层扫描/计算机断层扫描进行了初步评估。大多数患者接受了以蒽环类药物为基础的 NAC 方案（69 例，79.3%）和改良根治性乳房切除术（61 例，70.1%）。在91.5个月的中位随访期间，10名患者仅出现远处转移（DM），2名患者出现孤立的局部复发，1名患者出现局部复发和DM，另一名患者出现局部复发、区域复发和DM。5年的局部复发率、DM率、任何复发率（AR）和总生存率（OS）分别为1.2%、11.6%、11.6%和90.8%。风险组是复发的独立预后因素，高风险组的DM（19.2%对0%，P=0.009）、AR（19.2%对0%，P=0.016）和OS（82.8%对100%，P=0.001）率较低。根据临床和免疫组化风险因素划分的临床风险组是生存和复发的绝佳预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Imaging and Radiation Oncology 医学-核医学

CiteScore

3.30

自引率

6.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.