Bushra Rehman,Osama  Shakeel,Sara  Rehman,Naseera  Khanum,Ruqaya  Naheed,M.  Abubakar,Amina  I. Khan,Huma  M. Khan,Zulqarnain  Chuadhary,M. Asad  Parvaiz,
Predictive Factors Involved in Determining Response to Neoadjuvant Chemotherapy in Breast Cancer and Impact of Response on 5 Years Disease Free Survival and Overall Survival
Clinical Oncology and Research
2020
2613-4942
http://dx.doi.org/10.31487/j.COR.2020.08.05
https://www.sciencerepository.org/predictive-factors-involved-in-determining-response-to-neoadjuvant-chemotherapy_COR-2020-8-105 
Abstract: Objective: To evaluate all the known factors that may play a role in predicting response to Neoadjuvant
chemotherapy in breast cancer and to see impact of response on five years’ disease free survival (DFS) and
Overallsurvival (OS).
Material and Method: Data of 156 patients was reviewed retrospectively from January 2012 to December
2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received
neoadjuvant chemotherapy (NAC) and had no distant metastasis. The response was measured in term of
percentage reduction from 1st radiological size on presentation to final size on histopathology (of resected
specimen). Four groups were identified, complete responder (CR) (100% reduction), Responders (R) (>50%
reduction), Partial responder (PR) (<50% reduction) and Non-responder (NR). Relationship of predictive
factors with each response group was observed. Five year survival was noted for each response group.
Result: Median age of patients was 45 years (25-64 years). 67% of patients underwent breast conservation
surgery, while the rest underwent mastectomy. Mortality for whole group was 22%, and recurrence was
shown in 34% (Majority i.e. 26% were distant, while contralateral were 3%). Out of 156 patients, 25% of
patients were CR, 13% were NR, 23% were PR and 37% were R. Progesterone receptor negative and Grade
III tumors showed more complete responses. The Rest of the receptor types, including triple negative, initial
T and N stage and other clinical factors showed no impact on chemo-response. Survival was significantly
poor in NR group (45% OS, 40% DFS), while rest of three groups had comparable survival outcome, with
CR group having best survival outcome (86% OS, 80% DFS).
Conclusion: Most of factors studied did not show impact on achieving good chemo response, however good
chemo response did show better survival.Keywords: Neo-adjuvant chemotherapy, response of neo-adjuvant, breast cancer, long-term survival after neo-adjuvant, therapy for breast cancer