title: Clinical usefulness of AJCC response criteria for neoadjuvant chemotherapy in breast cancer.
abstract: OBJECTIVE
  Recently, the American Joint Committee on Cancer (AJCC) 7th edition proposed new response criteria for neoadjuvant chemotherapy (NAC) in breast cancer. The purpose of this study was to evaluate the clinical usefulness of AJCC response criteria.
  
  
  METHODS
  A total of 398 consecutive stage II or III breast cancer patients who received NAC were enrolled in this study. AJCC response criteria were as follows: (1) complete response (CR)-absence of invasive carcinoma in the breast and node; (2) partial response (PR)-decrease in either or both T or N stage; (3) no response (NR)-no change or increase in either or both T or N stage.
  
  
  RESULTS
  Complete response, PR, and NR by AJCC criteria were 9.8, 59.3, and 30.7 %, respectively. Among the 398 patients, 337 patients were available for both paired pre- and post- breast MRI and chest CT. AJCC response criteria were significantly associated with RECIST criteria (P < 0.001). AJCC response was significantly associated with relapse-free survival (RFS) and overall survival (OS). The 5-year RFS rates were 89.6 % in CR, 74.1 % in PR, and 62.6 % in NR (P = 0.002). The 5-year OS rates were 97.4 % in CR, 88.6 % in PR, and 78.3 % in NR (P = 0.012). When adjusting potential prognostic factors, AJCC response was independently associated with RFS and OS.
  
  
  CONCLUSIONS
  AJCC response criteria for NAC in breast cancer have clinical usefulness in evaluating response of NAC, as well as predicting survival. AJCC response criteria can discriminate among patient subgroups with respect to survival.
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Bhumsuk
authors.initials: B
authors.lastname: Keam
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.forename: Yoojoo
authors.initials: Y
authors.lastname: Lim
authors.forename: Sae-Won
authors.initials: SW
authors.lastname: Han
authors.forename: Hyeong-Gon
authors.initials: HG
authors.lastname: Moon
authors.forename: Do-Youn
authors.initials: DY
authors.lastname: Oh
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Wonshik
authors.initials: W
authors.lastname: Han
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Kim
authors.forename: Tae-You
authors.initials: TY
authors.lastname: Kim
authors.forename: In Ae
authors.initials: IA
authors.lastname: Park
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Noh
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012372:ROC Curve; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult