Pathologic Complete Response and Oncologic Outcomes in Locally Advanced Breast Cancers Treated With Neoadjuvant...

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Locally advanced and high-risk breast cancers often require multimodal treatment.
• Neoadjuvant therapy aims to downstage tumors before surgery.
• Evaluating the role of neoadjuvant radiation therapy (NART) in conjunction with chemotherapy and immediate reconstruction is crucial.

Purpose of the Study:

• To assess pathologic complete response (pCR) rates after NART.
• To determine postoperative surgical complication rates.
• To evaluate oncological outcomes, including survival, in patients treated with NART.

Main Methods:

• Retrospective, multi-institutional review of 138 patients with 140 breast cancers.
• Sequential neoadjuvant chemotherapy and NART followed by mastectomy and immediate autologous breast reconstruction.
• Kaplan-Meier analysis for locoregional recurrence-free, distant metastasis-free, and overall survival.

Main Results:

• Pathologic complete response (pCR) rates were 36.4% (Chevallier) or 42.1% (Miller-Payne).
• Higher pCR rates observed in HER2+ (73.8%-85.7%) and triple-negative (47.6%-57.1%) breast cancer subtypes.
• 3-year survival rates: locoregional recurrence-free (98.1%), distant metastasis-free (83.6%), and overall (95.3%).

Conclusions:

• NART is feasible for single-stage mastectomy and immediate autologous breast reconstruction.
• Postoperative complication rates were comparable to standard treatment protocols.
• High pCR rates correlate with favorable locoregional control and long-term survival outcomes.