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  3. 32. Response of Neoadjuvant Chemotherapy in Triple Negative Breast Cancer and the impact of Pathologic Complete Response on Survival
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32. Response of Neoadjuvant Chemotherapy in Triple Negative Breast Cancer and the impact of Pathologic Complete Response on Survival

Susheel Kumar1, Iqtedar Ahmed Moazzam1, Waqas Ishtiaq Ali1 and Naveed Lodhi2

ABSTRACT

Objective: To evaluate response of neoadjuvant chemotherapy (NACT) in stage I-III triple negative breast cancer (TNBC) and impact of pathologic complete response (pCR) on survival.

Study Design: Descriptive / Cross-sectional study

Place and Duration of Study: This study was conducted at the Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan between January 2010 to July 2016.

Materials and Methods: All patients with TNBC who received NACT were included and data was abstracted from cancer registry of hospital. The patients received NACT followed by surgery. Radiotherapy was given wherever clinically indicated. Kaplan-Meier and log-rank test was used to calculate survival.

Results: Out of 1113 TNBC patients, 150 received NACT. Mean age was 43 ± 7 years. Fifty-two patients (34.7%) achieved pCR(defined as complete eradication of invasive or in situ carcinoma in breast and axilla (ypT0/is/ypN0) in surgical specimen). Over a median follow up of 61 months, 52 patients (34.7%) had disease progression. In pCR group, only 5 patients (9.6%)had disease progression whereas in non-pCR group, 47 patients (48%)experienced disease progression. Patients who achieved pCR had significantly better 5-yearsdisease-free survival (DFS) (p-value0.001) and 5-years overall survival (OS)(p-value0.002) in comparison to non-pCR group. The 5-years DFS was 90% in pCR group compared to 55% in non-pCR group. Similarly, 5-years OS was 94% in pCR group compared to 70% non-pCR group.

Conclusion: NACT is an effective treatment modality in management of TNBC. Achievement of pCR is a potential surrogate endpoint as it is associated with significantly better DFS and OS.

Key Words: Disease free survival (DFS), Overall survival (OS), Pathologic complete response (pCR), Triple negative breast cancer (TNBC).

Citation of article: Kumar S, Moazzam IA, Ali WI, Lodhi N. Response of Neoadjuvant Chemotherapy in Triple Negative Breast Cancer and the impact of Pathologic Complete Response on Survival. Med Forum 2020;31(12):139-143.