Correlation between Tumor Response to Neoadjuvant Chemotherapy and Patient Outcome in Breast Cancer

Kim, Je Ryong; Pack, Hye Duck; Chang, Eil Sung

Abstract

PURPOSE: Neoadjuvent chemotherapy is being used increasingly in the treatment of patient with large or locally advanced breast cancer with the aim of downstaging and eliminating micrometastasis. We report the correlation between tumor response to preoperative primary chemotherapy and patient outcome in the consecutive series of a 73 patients with breast cancer
METHODS
From Feb. 1991 to Oct. 1998, 73 patients with breast cancer(tumor size>3 cm, or clinically axillary node positive) were treated with multimodality therapy including sandwitch type of chemotherapy comprised of preoperative 3 cylcles and postoperative 3 cycles of FEC or MMM. The median follow-up period was 53 months.
RESULTS
The overall objective clinical response rate(complete & partial response) of the primary tumor to chemotherapy was 75.5%(standard UICC criteria). The pathologic complete response rates was 9.6%.The overall 5- year survival rate was 86.8%, and the overall 5-year disease free survival rate 82.6%. As with increasing the tumor size, the response rates to chemotherapy was declined. But there was no relationship between clinical response to chemotherapy and menopausal status, chemotherapeutic regimen, and histopathologic type. Breast conserving operation was done in 64.4% as a result of decrease in tumor size.
CONCLUSION
Neoadjuvent chemotherapy enables breast conserving operation more frequently in large or locally advanced breast cancer. Responses to neoadjuvent chemotherapy is a powerful prognostic factor on overall survival and disease free survival in breast cancer patients.