A new prognostic classification after primary chemotherapy for breast cancer: residual disease in breast and nodes (RDBN).
OBJECTIVE
Several factors have been shown to correlate with prognosis of patients with breast carcinoma. Among the most useful are node involvement, tumor size, and pathologic grade. These factors retained their prognostic value when assessed after neoadjuvant chemotherapy.


METHODS
Previously we used a revised Nottingham prognostic index and defined 3 related indices (breast grading index, modified Nottingham prognostic index, and modified breast grading index) that were also significantly related to overall survival and disease-free survival. To assess the postchemotherapy risk globally, we have combined the 3 pathologic factors to design a specific classification to evaluate residual disease. This new classification includes 4 risk levels (levels 1-4) according to residual disease magnitude after neoadjuvant chemotherapy in 710 patients with operable breast cancer.


RESULTS
This classification resulted in significantly different results for overall survival (P < 10(-7)) and disease-free survival (P = 8.3 x 10(-7)).


CONCLUSIONS
This classification should help us in the selection of subgroups of patients for further adjuvant treatment.
Chollet
Philippe
P
Centre Jean Perrin, Clermont Ferrand, France.
Abrial
Catherine
C
Durando
Xavier
X
Thivat
Emilie
E
Tacca
Olivier
O
Mouret-Reynier
Marie-Ange
MA
Leheurteur
Marianne
M
Kwiatkowski
Fabrice
F
Dauplat
Jacques
J
Penault-Llorca
Frédérique
F
Penault-Llorc
Frédérique
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual / Q000145:classification* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis
D000970:Antineoplastic Agents