title: Factors predicting treatment responsiveness and prognosis in node-negative breast cancer. The International (Ludwig) Breast Cancer Study Group.
abstract: OBJECTIVE
  An international trial (formerly Ludwig Trial V) has been conducted in 1,275 subjects to ascertain if perioperative chemotherapy is beneficial for node-negative breast cancer patients and to identify subgroups of patients who benefit from this therapy.
  
  
  METHODS
  Node-negative breast cancer patients were randomized to receive either one cycle of perioperative chemotherapy or no adjuvant treatment. A detailed pathology review was conducted in 1,203 of the 1,275 patients enrolled. Stepwise Cox regression analysis was used to search for factors either predicting chemotherapeutic responsiveness and/or influencing disease-free survival (DFS).
  
  
  RESULTS
  As expected, primary tumor size, grade, and the presence of peritumoral vascular invasion are the most important prognostic factors. Perioperative chemotherapy provides a DFS advantage at 5 years of median follow-up and such treatment is more effective for estrogen receptor-negative than for estrogen receptor-positive tumors, for histologic grade 2 and 3 than for grade 1 tumors, and for patients in whom no axillary lymph node metastases were found even after serial sectioning and review by the Central Pathology Laboratory.
  
  
  CONCLUSIONS
  Hormone receptor status and tumor grade are important factors for predicting responsiveness to perioperative chemotherapy in node-negative breast cancer.
authors.affiliation: International Breast Cancer Study Group, Bern, Switzerland.
authors.forename: A M
authors.initials: AM
authors.lastname: Neville
authors.forename: R
authors.initials: R
authors.lastname: Bettelheim
authors.forename: R D
authors.initials: RD
authors.lastname: Gelber
authors.forename: J
authors.initials: J
authors.lastname: Säve-Söderbergh
authors.forename: B W
authors.initials: BW
authors.lastname: Davis
authors.forename: R
authors.initials: R
authors.lastname: Reed
authors.forename: J
authors.initials: J
authors.lastname: Torhorst
authors.forename: R
authors.initials: R
authors.lastname: Golouh
authors.forename: H F
authors.initials: HF
authors.lastname: Peterson
authors.forename: K N
authors.initials: KN
authors.lastname: Price
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011960:Receptors, Estrogen / Q000032:analysis*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D011960:Receptors, Estrogen