Title

Effects of Neoadjuvant Chemotherapy on Locally Advanced Breast Cancer: A Clinicopathological Study

Translated Titles

術前化學治療在局部進行性乳癌之效應:臨床病理研究

DOI

10.29833/FJS.200512.0001

Authors

羅玉幸(Yu-Shing Lo);曾暉華(Hwi-Hwa Tseng);吳銘庭(Ming-Ting Wu);郭耀昌(Yau-Chang Kuo);周春平(Chen-Pin Chou);張倩毓(Chien-Yu Chang);張宏泰(Hong-Tai Chang)

Key Words

biomarkers ; breast cancer ; neoadjuvant chemotherapy

PublicationName

Formosan Journal of Surgery

Volume or Term/Year and Month of Publication

38卷6期(2005 / 12 / 01)

Page #

267 - 273

Content Language

英文

Chinese Abstract

Objective: Neoadjuvant chemotherapy (NAC) is the mainstream treatment for locally advanced breast cancer, and the effects of NAC have been widely discussed in terms of morphology and biomarkers. In this study we quantify the changes in biomarkers and analyze the morphological changes after NAC. Methods: Paired histological tumor samples before and after NAC were obtained from 17 breast cancer patients diagnosed as invasive ductal carcinoma by core needle biopsy or incision biopsy at Kaohsiung Veterans General Hospital between 2001 and 2003. One patient who died of breast cancer was excluded. The remaining 16 cases received 2-6 cycles of chemotherapy with regimens of 5FU, epirubicin and cyclophosphamide (FEC). The effects of NAC on 13 morphometries and the expression of biomarkers (ER, PR, p53 and Her-2/neu) were analyzed. Tumor size was evaluated by both high spatial resolution MRI (HSR-MRI) and histomorphology change, which were used to survey the response to NAC. Results: In all the 17 cases, the most prominent histological features included thickening of the basement membrane and nuclear atypia. In multivariate analysis, NAC showed a dependent role for expression of Her-2/neu (p=0.033), but an independent role for ER, PR and p53. Age also played an independent role. Further more, proportion of necrosis, fibrosis and tumor size present in HSR-MRI all had good correlations with changes in histomorphology (p<0.05). Conclusion: According to the results of our study and the previous literature, biomarkers of breast cancer may change with time, and repeating a study of biomarkers may be necessary for clinicians to decide what regimens will be most effective in the next course of chemotherapy.

English Abstract

Objective: Neoadjuvant chemotherapy (NAC) is the mainstream treatment for locally advanced breast cancer, and the effects of NAC have been widely discussed in terms of morphology and biomarkers. In this study we quantify the changes in biomarkers and analyze the morphological changes after NAC. Methods: Paired histological tumor samples before and after NAC were obtained from 17 breast cancer patients diagnosed as invasive ductal carcinoma by core needle biopsy or incision biopsy at Kaohsiung Veterans General Hospital between 2001 and 2003. One patient who died of breast cancer was excluded. The remaining 16 cases received 2-6 cycles of chemotherapy with regimens of 5FU, epirubicin and cyclophosphamide (FEC). The effects of NAC on 13 morphometries and the expression of biomarkers (ER, PR, p53 and Her-2/neu) were analyzed. Tumor size was evaluated by both high spatial resolution MRI (HSR-MRI) and histomorphology change, which were used to survey the response to NAC. Results: In all the 17 cases, the most prominent histological features included thickening of the basement membrane and nuclear atypia. In multivariate analysis, NAC showed a dependent role for expression of Her-2/neu (p=0.033), but an independent role for ER, PR and p53. Age also played an independent role. Further more, proportion of necrosis, fibrosis and tumor size present in HSR-MRI all had good correlations with changes in histomorphology (p<0.05). Conclusion: According to the results of our study and the previous literature, biomarkers of breast cancer may change with time, and repeating a study of biomarkers may be necessary for clinicians to decide what regimens will be most effective in the next course of chemotherapy.

Topic Category 醫藥衛生 > 外科