title: Pathological response and survival after neoadjuvant therapy for breast cancer: a 30-year study.
abstract: OBJECTIVE
  HER2-positive and triple-negative breast cancer (TNBC) still have a poor prognosis. Pathological complete response (pCR) is usually considered a surrogate marker for outcome. The aim of this study was to reconsider these parameters on a large population after a long follow-up. 348 patients with unilateral breast cancer who received neoadjuvant treatment at our institution over 30 years were included.
  
  
  RESULTS
  Patients were classified according to hormonal receptors (HR) and HER2. Median follow-up was 7 years. pCR was significantly lower in HR+/HER2- tumors (P < 0.0001). The 7-year OS rates were 76.1% (HR+/HER2-), 60.1% (TNBC), 72.4% (HR+/HER2+), and 49.9% (HR-/HER2+). Disease-free survival (DFS) and OS differed significantly according to pCR. Among HER2+ patients, pCR rate, DFS and OS were greater with trastuzumab.
  
  
  CONCLUSIONS
  TNBC and HR-/HER2+ tumors have the worst outcome. pCR remains a significant prognostic factor. Trastuzumab strongly improves pCR and survival in HER2+ tumors.
authors.affiliation: Department of Medical Oncology, Georges-François Leclerc Cancer Center, Dijon, France. sguiu@cgfl.fr
authors.forename: Séverine
authors.initials: S
authors.lastname: Guiu
authors.forename: Laurent
authors.initials: L
authors.lastname: Arnould
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.forename: Cécile
authors.initials: C
authors.lastname: Dalban
authors.forename: Laure
authors.initials: L
authors.lastname: Favier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Desmoulins
authors.forename: Gilles
authors.initials: G
authors.lastname: Créhange
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.forename: Pierre
authors.initials: P
authors.lastname: Fumoleau
authors.forename: Bruno
authors.initials: B
authors.lastname: Coudert
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry* / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D000068878:Trastuzumab