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Predictive factors for axillary pathological complete response to neoadjuvant therapy in elderly breast cancer patients

  • 0School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Bmc Cancer +

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January 28, 2025

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January 28, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Predicting axillary pathological complete response (apCR) in elderly breast cancer patients undergoing neoadjuvant therapy (NAT) is crucial. Initial clinical lymph node negative (cN0) stage and HER2 positivity are key predictors for apCR, potentially avoiding axillary lymph node dissection (ALND).

Area Of Science

  • Oncology
  • Breast Cancer Research
  • Clinical Pathology

Background

  • Elderly breast cancer patients require tailored treatment strategies.
  • Neoadjuvant therapy (NAT) is a standard treatment approach.
  • Axillary lymph node status is critical for treatment decisions and prognosis.

Purpose Of The Study

  • To identify predictive factors for axillary pathological complete response (apCR) in elderly breast cancer patients receiving NAT.
  • To establish criteria for axillary lymph node retention in this patient group.

Main Methods

  • Retrospective analysis of 109 elderly breast cancer patients treated with NAT and surgery.
  • Investigation of clinicopathological characteristics and their correlation with apCR.
  • Univariate (chi-square/Fisher's exact test) and multivariate (binary logistic regression) analyses were performed.

Main Results

  • Overall apCR rate was 46.8%.
  • Initial cN0 stage, HER2 positivity, and breast pathological complete response (bpCR) were significant univariate predictors of apCR.
  • Multivariate analysis confirmed initial cN0 stage and HER2 positivity as independent predictors of apCR.
  • HER2-positive, cN0 patients achieved 100% apCR, while HER2-negative, cN+ patients had the lowest apCR (36.0%).

Conclusions

  • Initial cN0 stage and HER2 positivity are independent predictors of apCR in elderly breast cancer patients post-NAT.
  • HER2-positive elderly patients with initial cN0 disease may be candidates for avoiding axillary lymph node dissection (ALND) after NAT.

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