title: Clinical features associated with a favorable outcome following neoadjuvant chemotherapy in women with localized breast cancer aged 35 years or younger.
abstract: BACKGROUND
  There is scarce data on the outcome of young patients aged 35 years and younger, who have been treated with neoadjuvant chemotherapy. The aim of this study is to evaluate the impact of body mass index (BMI) and various prognostic factors on pathologic response and survival in young patients with localized breast cancer.
  
  
  METHODS
  This is a retrospective evaluation on the outcome of 110 patients who were younger than 35 years at diagnosis and treated with neoadjuvant chemotherapy (CT). Patients were grouped in quartiles of BMI calculated prior to initiation of chemotherapy. Logistic regression analysis was performed to investigate the associations between prognostic variables including BMI and treatment outcome. The impact of prognostic factors on survival was analyzed by Kaplan-Maier and Cox regression tests.
  
  
  RESULTS
  Body mass index was not correlated with pathologic complete response (pCR) (n = 13, 11.7%) or survival. Cox regression analysis revealed nodal pCR following neoadjuvant chemotherapy (HR 2.45, P = 0.048) and stage at diagnosis (HR1.99, P = 0.027) as significant independent prognostic factors for DFS, while recurrence was independently associated with shorter OS (HR 169, P = 0.029).
  
  
  CONCLUSIONS
  Body mass index was not correlated with pCR or prognosis in young women with early breast cancer. Pathologic CR was shown to have a significant influence on DFS. Total axillary clearance may be used a surrogate variable in determining prognosis in young patients treated with neoadjuvant chemotherapy.
authors.affiliation: Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA, yeralp@yahoo.com.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Eralp
authors.forename: Terry L
authors.initials: TL
authors.lastname: Smith
authors.forename: Kadri
authors.initials: K
authors.lastname: Altundağ
authors.forename: Shu-Wan
authors.initials: SW
authors.lastname: Kau
authors.forename: Jennifer
authors.initials: J
authors.lastname: Litton
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.forename: Aman
authors.initials: A
authors.lastname: Buzdar
authors.forename: Gabriel N
authors.initials: GN
authors.lastname: Hortobagyi
authors.forename: Banu
authors.initials: B
authors.lastname: Arun
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008499:Medical Records; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome