title: A new prognostic classification after primary chemotherapy for breast cancer: residual disease in breast and nodes (RDBN).
abstract: 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.
authors.affiliation: Centre Jean Perrin, Clermont Ferrand, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chollet
authors.forename: Catherine
authors.initials: C
authors.lastname: Abrial
authors.forename: Xavier
authors.initials: X
authors.lastname: Durando
authors.forename: Emilie
authors.initials: E
authors.lastname: Thivat
authors.forename: Olivier
authors.initials: O
authors.lastname: Tacca
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Mouret-Reynier
authors.forename: Marianne
authors.initials: M
authors.lastname: Leheurteur
authors.forename: Fabrice
authors.initials: F
authors.lastname: Kwiatkowski
authors.forename: Jacques
authors.initials: J
authors.lastname: Dauplat
authors.forename: Frédérique
authors.initials: F
authors.lastname: Penault-Llorca
authors.forename: Frédérique
authors.initials: F
authors.lastname: Penault-Llorc
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents