[Early Recurrence of Triple Negative Breast Cancer with Pathological Complete Response Following Neoadjuvant...

In this study, we report the case of a patient with triple-negative breast cancer who achieved a pathological complete response(pCR)following neoadjuvant chemotherapy but experienced early recurrence and had a poor prognosis. A 46-year-old woman with a diagnosis of triple-negative breast cancer(cT2cN3cM0, cStage ⅢC)received neoadjuvant chemotherapy with dose-dense doxorubicin and cyclophosphamide, followed by weekly paclitaxel. The patient underwent a mastectomy and axillary lymph node dissection, achieving pCR. Subsequently, she received postmastectomy radiation therapy. As the patient was diagnosed with a pathogenic BRCA2 variant, a risk-reducing salpingo-oophorectomy was scheduled. However, liver metastases were detected on a preoperative PET-CT scan 7 months after surgery. Therefore, the patient was treated with olaparib followed by chemotherapy but died 15 months after surgery because of treatment inefficacy. Certain studies describe early TNBC recurrence in patients with pCR within 3 years after surgery, with cN1 or higher being common. Clinicians should be aware of potential TNBC recurrence in patients with pCR, especially within 3 years. Additionally, in the KEYNOTE-522 study, the hazard ratio for the pembrolizumab group compared to the placebo group was 0.73 in the event-free survival analysis of patients with pCR. Therefore, it is recommended that patients receive chemotherapy in combination with pembrolizumab.