Residual Cancer Burden Index as a Predictor of Recurrence Following Neoadjuvant Chemotherapy in Breast Cancer...

With increasing use of neoadjuvant chemotherapy (NAC) in breast cancer, it is important to standardize the assessment of tumor response to systemic therapy by pathologists. The Residual Cancer Burden (RCB) quantifies residual disease after NAC. In a series of 185 patients treated by NAC, we assessed the prognostic value of the Residual Cancer Burden (RCB) index. We analyzed the association between RCB index and disease-free survival (DFS), after stratification by BC subtypes. One hundred eighty-five. patients were included (luminal (n = 65, 35.1%), TNBC (n = 75, 40.5%), HER2-positive (n = 45, 24.32%)). After a median follow-up of 49.6 months (9.2-72 months), 23 patients experienced relapse in our study. Among 112 patients with residual disease, RCB index repartition was as follows: RCB-I: n = 23 (12.4%), RCB-II: n = 72 (39.5%), and RCB-III: n = 17 (9.1%). Among pre-NAC parameters, RCB class was not significantly different apart from hormone and HER2 receptor status (p < 0.001). Higher RCB class was significantly correlated with the presence of nodal involvement (p < 0.001). Increasing RCB was associated with an increased risk of relapse. Five-year disease-free survival was good in the RCB-0 and RCB-I groups (58.4 months (95% C.I [56.9-60.4]) and 58 months (95% C.I [56.6-61.0]) respectively)), whereas the prognosis was intermediate in RCB-II patients 54 months (95% C.I [52.0-57.6]) and poor in RCB-III patients 47 months (95% C.I [39.5-54.7])). RCB index displays high prognostic performances to stratify survival outcome of patients. Based on the RCB score, you can accurately identify high-risk patients and calibrate further adjuvant therapy and individualize follow-up strategies. The study demonstrated the simplicity and ease of reciprocation of RCB measurement and supports incorporating it within standardized pathology reporting guidelines.