Clinicopathological factors predictive of pathological response and impact on disease-free survival in breast cancer: Analysis from a tertiary cancer centre in South India

Abstract

Aim: Neoadjuvant chemotherapy in carcinoma breast results in tumour downstaging and provides the opportunity to modify treatment based on response. Pathological complete response (pCR) is considered predictive of favourable long-term outcomes. The objective was to identify clinicopathological factors associated with pCR in breast cancer and disease-free survival (DFS). Subjects and Methods: Clinicopathological details of 106 breast cancer patients receiving neoadjuvant therapy were retrospectively analyzed. The statistical analyses were performed using the Chi-square test by SPSS software (version 18.0). Pvalues were considered statistically significant when <0.05. Results: The median age of the patients was 53 years. The overall pCR rate was 23.6%. From univariate analysis, a significant rate of pCR was detected in tumours with high grade or high Ki-67 scores (P = 0.001, P = 0.019), respectively. 29 patients relapsed of which 21 were distant metastasis. On Kaplan–Meier method analysis, statistically significant factors associated with decreased DFS were high Ki 67 and lymphovascular invasion positivity. Distant metastasis occurred in 4 patients with pCR and 19 patients without pCR. The 5-year DFS rate was 84% versus 69% in patients with pCR and without pCR, respectively. Conclusion: A higher rate of pCR was obtained with neoadjuvant therapy in tumours with high grade or Ki-67. Longer DFS is achieved by obtaining pCR with ideal neoadjuvant selection.