title: Prognostic impact of tumor lymphocytic infiltrates in patients with breast cancer undergoing neoadjuvant chemotherapy.
abstract: OBJECTIVE
  The presence of a pronounced tumor lymphocytic infiltrate (TLI) is deemed to reflect the presence of an immunoinflammatory response against the tumor and may thus have prognostic significance. We investigated the prognostic value of TLI detected in pathological specimens collected following neoadjuvant chemotherapy (NACT) in patients with breast cancer.
  
  
  METHODS
  100 consecutive patients with breast cancer (mean age 47.8±11.4 years) who were scheduled to undergo anthracycline-and/or taxane-containing NACT were enrolled. Specimens collected after NACT were scored with the 4-point Klintrup scoring criteria for the presence of TLI.
  
  
  RESULTS
  60 patients had low-grade TLI and 40 high-grade TLI. Comparison of the patient population according to low-grade vs high-grade TLI revealed statistically significant difference both in terms of disease-free survival (DFS) (log rank-4.28, p<0.05) and overall survival (OS) (log rank=3.96, p<0.05), with high-grade TLI patients showing a better prognosis. Multivariate Cox regression analysis identified postoperative tumor size and low-grade TLI as the two main independent adverse prognostic factors.
  
  
  CONCLUSIONS
  High-grade TLI may interfer with tumor growth and can represent a favorable prognostic factor in women with breast cancer undergoing NACT.
authors.affiliation: Department of Medical Oncology, Ali Osman Sonmez Oncology Hospital, Bursa, Turkey.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Avci
authors.forename: Adem
authors.initials: A
authors.lastname: Deligonul
authors.forename: Sahsine
authors.initials: S
authors.lastname: Tolunay
authors.forename: Erdem
authors.initials: E
authors.lastname: Cubukcu
authors.forename: Omer
authors.initials: O
authors.lastname: Fatih Olmez
authors.forename: Ozgur
authors.initials: O
authors.lastname: Altmisdortoglu
authors.forename: Ozgur
authors.initials: O
authors.lastname: Tanriverdi
authors.forename: Asude
authors.initials: A
authors.lastname: Aksoy
authors.forename: Ender
authors.initials: E
authors.lastname: Kurt
authors.forename: Turkkan
authors.initials: T
authors.lastname: Evrensel
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D011446:Prospective Studies