Prognosis and influencing factors of ER-positive, HER2-low breast cancer patients with residual disease after neoadjuvant chemotherapy: a retrospective study

作者全名：Tang, Lingfeng; Jiang, Linshan; Shu, Xiujie; Jin, Yudi; Yu, Haochen; Liu, Shengchun

作者地址：[Tang, Lingfeng; Jiang, Linshan; Shu, Xiujie; Yu, Haochen; Liu, Shengchun] Chongqing Med Univ, Dept Breast & Thyroid Surg, Affiliated Hosp 1, 1 Youyi Rd,Yuanjiagang, Chongqing 400016, Peoples R China; [Jin, Yudi] Chongqing Univ, Canc Hosp, Dept Pathol, Chongqing, Peoples R China

通信作者：Yu, HC; Liu, SC (通讯作者)，Chongqing Med Univ, Dept Breast & Thyroid Surg, Affiliated Hosp 1, 1 Youyi Rd,Yuanjiagang, Chongqing 400016, Peoples R China.

来源：SCIENTIFIC REPORTS

ESI学科分类：Multidisciplinary

WOS号：WOS:001230489600032

JCR分区：Q1

影响因子：3.8

年份：2024

卷号：14

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Neoadjuvant chemotherapy; Breast cancer; Estrogen receptor; HER2-low; Prognosis

摘要：Previously, we found that patients with estrogen receptor (ER)-positive, HER2-low breast cancer are resistant to neoadjuvant chemotherapy (NACT) and have worse outcomes than those who achieve pathological complete response (pCR) after NACT. This study aimed to investigate the prognosis and influencing factors in these patients. A total of 618 patients with ER-positive breast cancer who received standard thrice-weekly NACT were enrolled, including 411 patients with ER-positive, HER2-low breast cancer. Data on the clinicopathological features of these patients before and after NACT were collected. Univariate and multivariate Cox regression analyses were used to identify the independent factors affecting 5-year disease-free survival (DFS). Among the ER-positive, HER2-low patients, 49 (11.9%) achieved a pCR after NACT. A significant difference in survival was observed between patients with and without residual disease after NACT. Additionally, changes in immunohistochemical markers and tumor stages before and after NACT were found to be significant. According to univariate and multivariate analyses, cN_stage (P = 0.002), ER (P = 0.002) and Ki67 (P = 0.023) expression before NACT were significantly associated with 5-year DFS, while pT_stage (P = 0.015), pN_stage (P = 0.029), ER (P = 0.020) and Ki67 (P < 0.001) levels after NACT were related to 5-year DFS in ER-positive, HER2-low patients with residual disease. Our study suggested that high proliferation, low ER expression and advanced stage before and after NACT are associated with a poor prognosis, providing useful information for developing long-term treatment strategies for ER-positive, HER2-low breast cancer in patients with residual disease in the future.

基金机构：The First Clinical College Clinical medicine first-class discipline construction project to department of Breast and Thyroid Surgery

基金资助正文：The authors wish to thank all the study participants, research staff and students who participated in this work.