title: Favorable outcome in patients with breast cancer in the presence of pathological response after neoadjuvant endocrine therapy.
abstract: Neoadjuvant endocrine therapy (NAET) can expand the number of breast cancer patients who can be treated with breast-conserving surgery and can predict benefit from adjuvant endocrine therapy. Because no validated surrogate markers for long-term outcome have been established, we conducted prospective trials to evaluate pathological response and Ki-67 index following treatment with tamoxifen or anastrozole. The study population included postmenopausal women with operable breast tumors that were both estrogen and progesterone receptor-positive and larger than 3 cm. Response was classified as pathological response (minimal response or better) and non-response. Non-responding (25.5%, vs. response 85.9%, p=0.002), axillary node-positive (58.4% vs. node negative 100%, p=0.045), and high pretreatment Ki-67 index (41.4% vs. low Ki-67 87.1%, p=0.03) patients were significantly associated with poor 5-year relapse-free survival. Multivariate analysis of relapse-free survival indicated that pathological response was independent. Therefore, pathological response may be a favorable prognostic factor after NAET.
authors.affiliation: Division of Breast Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan. sakashi@ncc.go.jp
authors.forename: Sadako
authors.initials: S
authors.lastname: Akashi-Tanaka
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Omatsu
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Masashi
authors.initials: M
authors.lastname: Ando
authors.forename: Kotoe
authors.initials: K
authors.lastname: Terada
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Seki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukutomi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D009570:Nitriles / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000627:therapeutic use*; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D020845:Selective Estrogen Receptor Modulators; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole