title: The response to neoadjuvant chemotherapy predicts clinical outcome and increases breast conservation in advanced breast cancer.
abstract: BACKGROUND
  The aim of this study was to determine outcomes in patients with breast cancer treated with neoadjuvant chemotherapy.
  
  
  METHODS
  Seventy-two consecutive patients receiving neoadjuvant chemotherapy for breast cancer were enrolled.
  
  
  RESULTS
  Mastectomy was avoided in 46% of patients, and 42% converted to negative nodes after neoadjuvant chemotherapy. Thirteen patients (18%) achieved a pathologic complete response, which was associated with the estrogen receptor (ER)-negative/human epidermal growth factor receptor 2 (Her2)-negative subtype (58%) and was significantly less likely to occur in the ER+/Her2- subtype (2%) (P < .01). Patients with the ER+/Her2+ subtype were most likely to have no response or progression during chemotherapy, compared with those with the ER-/Her2- subtype (50% vs 0%, P = .01). Five-year survival for patients achieving a pathologic complete response was 100%, compared with 74% in the group with partial response and 48% in the group with no response or progression (P = .01).
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy for patients with advanced breast cancer provided prognostic information, allowed evaluation of response to chemotherapy, decreased the mastectomy rate, and potentially reduced the need for axillary lymph node dissection.
authors: Department of Surgery, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 1516 JCP, Iowa City, IA 52242-1086, USA.
authors: Philip M
authors: PM
authors: Spanheimer
authors: Jennifer C
authors: JC
authors: Carr
authors: Alexandra
authors: A
authors: Thomas
authors: Sonia L
authors: SL
authors: Sugg
authors: Carol E H
authors: CE
authors: Scott-Conner
authors: Junlin
authors: J
authors: Liao
authors: Ronald J
authors: RJ
authors: Weigel
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human
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