title: Pathological responses and long-term outcome analysis after neoadjuvant chemotheraphy in breast cancer patients from Kuwait over a period of 15 years.
abstract: OBJECTIVE
  The attainment of pathological complete response (pCR) after neoadjuvant chemotherapy has been taken as a surrogate marker for disease-free survival and overall survival. This is however dependent on various other parameters such as stage, grade, and biologic markers.
  
  
  METHODS
  This is a retrospective study of 365 patients with histologically confirmed non-met.astatic breast cancer patients treated with neoadjuvant chemotherapy at the Kuwait Cancer Control Centre between 1998 and 2009.
  
  
  METHODS
  A total of 365 breast cancer patients who had received neoadjuvant chemotherapy from 1998-2009 were analyzed for the relationship of pCR with hormone status, Her2 status, histopathological subtype. Survival analysis was also conducted.
  
  
  RESULTS
  Hormone receptor (HR) negative tumors had a higher pCR as against HR positive tumors, and the highest pCR in our analysis of pathological subtypes were seen in the HR+, Her2neu + and HR-, Her2neu + group. In our study, we could make out the paradoxes that well differentiated, and HR positive tumors had a better survival in spite of having lower pCR. The luminal A subtype also had a better overall survival than the triple negative subtype in spite of having lower pCR with neoadjuvant chemotherapy.
  
  
  CONCLUSIONS
  Though the achievement of pCR retains its significance, it is more prognostic in HR negative tumors. The importance of HR receptor status, grade, and histopathological subtype in the long-term survival has been emphasized.
authors.affiliation: Dr. Yamini Krishnan, Medical Oncology, Kuwait, Kuwait, T: +96524847608, yams23in@yahoo.com.
authors.forename: Yamini
authors.initials: Y
authors.lastname: Krishnan
authors.forename: Shafika A
authors.initials: SA
authors.lastname: Alawadhi
authors.forename: Sreedharan
authors.initials: S
authors.lastname: P S
authors.forename: Murali
authors.initials: M
authors.lastname: Gopal
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thuruthel
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007730:Kuwait; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone