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Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy
PURPOSE: Patients younger than age 35 that fail to achieve a pathologic complete response (pCR) after Neoadjuvant chemotherapy (NACT) tend to have worse long term outcomes. The purpose of our study was to assess the correlation between the conversion of immunohistochemical (IHC) markers and breast d...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592039/ https://www.ncbi.nlm.nih.gov/pubmed/31417311 http://dx.doi.org/10.2147/CMAR.S198844 |
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author | Zhao, Yue Wang, Xiaolei Huang, Yuanxi Zhou, Xianli Zhang, Dongwei |
author_facet | Zhao, Yue Wang, Xiaolei Huang, Yuanxi Zhou, Xianli Zhang, Dongwei |
author_sort | Zhao, Yue |
collection | PubMed |
description | PURPOSE: Patients younger than age 35 that fail to achieve a pathologic complete response (pCR) after Neoadjuvant chemotherapy (NACT) tend to have worse long term outcomes. The purpose of our study was to assess the correlation between the conversion of immunohistochemical (IHC) markers and breast density and investigate their association with pathological response and prognosis. METHODS: We included 119 patients younger than age 35 who failed to achieve a pCR after NACT in this analysis. We evaluated the clinical and pathological response to NACT by the Union for International Cancer control (UICC) and the Miller-Payne grading (MPG) systems, respectively. A breast density assessment was applied via mammography examination at the time of diagnosis. MPG and breast density (BD) have been combined to define a specific classification of three risk levels to evaluate the prognosis of these patients. RESULTS: The diameter changes of the tumors and lymph nodes were negatively associated with hormone receptor conversion and positively correlated with Ki67 conversion. A significantly large size change was observed in the groups demonstrating conversion from HER-2 (+) to (−). The variation level of IHC markers was related to MPG and BD and was associated with the survival rate of the patients. Patients with a high breast density and low Miller-Payne grading after NACT had a higher risk of distant metastases or local recurrences. CONCLUSION: ER, PR and Ki67 conversion are closely related to MPG, while PR and Ki67 conversion are closely related to BD. While ER and PR conversion are independent and significant predictors of disease free survival (DFS) and overall survival (OS), HER-2 and Ki67 conversion are only significant for DFS. This risk factor grouping provides a useful index to evaluate the risk of young women with breast cancer who fail to achieve a pCR. |
format | Online Article Text |
id | pubmed-6592039 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-65920392019-08-15 Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy Zhao, Yue Wang, Xiaolei Huang, Yuanxi Zhou, Xianli Zhang, Dongwei Cancer Manag Res Original Research PURPOSE: Patients younger than age 35 that fail to achieve a pathologic complete response (pCR) after Neoadjuvant chemotherapy (NACT) tend to have worse long term outcomes. The purpose of our study was to assess the correlation between the conversion of immunohistochemical (IHC) markers and breast density and investigate their association with pathological response and prognosis. METHODS: We included 119 patients younger than age 35 who failed to achieve a pCR after NACT in this analysis. We evaluated the clinical and pathological response to NACT by the Union for International Cancer control (UICC) and the Miller-Payne grading (MPG) systems, respectively. A breast density assessment was applied via mammography examination at the time of diagnosis. MPG and breast density (BD) have been combined to define a specific classification of three risk levels to evaluate the prognosis of these patients. RESULTS: The diameter changes of the tumors and lymph nodes were negatively associated with hormone receptor conversion and positively correlated with Ki67 conversion. A significantly large size change was observed in the groups demonstrating conversion from HER-2 (+) to (−). The variation level of IHC markers was related to MPG and BD and was associated with the survival rate of the patients. Patients with a high breast density and low Miller-Payne grading after NACT had a higher risk of distant metastases or local recurrences. CONCLUSION: ER, PR and Ki67 conversion are closely related to MPG, while PR and Ki67 conversion are closely related to BD. While ER and PR conversion are independent and significant predictors of disease free survival (DFS) and overall survival (OS), HER-2 and Ki67 conversion are only significant for DFS. This risk factor grouping provides a useful index to evaluate the risk of young women with breast cancer who fail to achieve a pCR. Dove 2019-06-20 /pmc/articles/PMC6592039/ /pubmed/31417311 http://dx.doi.org/10.2147/CMAR.S198844 Text en © 2019 Zhao et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Zhao, Yue Wang, Xiaolei Huang, Yuanxi Zhou, Xianli Zhang, Dongwei Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title | Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title_full | Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title_fullStr | Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title_full_unstemmed | Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title_short | Conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
title_sort | conversion of immunohistochemical markers and breast density are associated with pathological response and prognosis in very young breast cancer patients who fail to achieve a pathological complete response after neoadjuvant chemotherapy |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592039/ https://www.ncbi.nlm.nih.gov/pubmed/31417311 http://dx.doi.org/10.2147/CMAR.S198844 |
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