[Assessment of neoadjuvant chemotherapy in breast cancer patients].
OBJECTIVE
To assess the response of neoadjuvant chemotherapy and its influencing factors in the breast cancer patients.


METHODS
171 patients with stage II or operable stage III breast cancers were treated with neoadjuvant chemotherapy before surgery between January 2004 and May 2005. Of these, 160 received and completed > or =3 cycles of neoadjuvant chemotherapy, 11 received only 2 cycles. The regimens of neoadjuvant chemotherapy were: CEF (CTX, Epirubicin, 5-Fu); NE (Navelbine, Epirubicin); TEC (Taxotere, Epirubicin, CTX). Response of neoadjuvant chemotherapy was evaluated in all patients by palpation, ultrasonography and pathological methods.


RESULTS
Complete response rate and clinical objective response rate determined by clinical palpation (cCR, cOR), ultrasonography (sCR, sOR) and pathology (pCR) was 18.7% and 88.3%; 4.1% and 74.9%; 15.2%, respectively. The correspondence rate of the pCR with cCR and sCR was 43.8% and 42.9%, respectively. It was showed by univariate analysis that patient whose tumor was < or =3 cm in diameter, or ER negative or grade 3 were more likely to achieve a pCR than those whose tumor was >3 cm, or ER positive or grade 1. Logistic regression analysis showed that only tumor size was the significant predictive factor for response to neoadjuvant chemotherapy in patients with primary breast cancer.


CONCLUSIONS
Patient with small, or ER negative or grade 3 tumor may have better pathological response to neoadjuvant chemotherapy, particularly, the tumor size is more predictive of pCR. Palpation or ultrasonography may have a tendency either to under- or to overestimate pCR. Breast neoplasms/drug therapy;
Zhang
Bin
B
Department of Breast Diseases, Liaoning Province Cancer Hospital, Shenyang 110042, China. zhangbin@medmail.com.cn
Zhang
Qiang
Q
Zhao
Lin
L
Long
Fei
F
Li
Shuang
S
Jiang
Da-qing
DQ
Xu
Hong
H
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012074:Remission Induction; D043823:Taxoids / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin; D014747:Vinblastine; D003520:Cyclophosphamide; D066246:ErbB Receptors; D000077235:Vinorelbine; D005472:Fluorouracil