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Open Access 01-12-2007 | Research article

Prognostic impact of clinicopathologic parameters in stage II/III breast cancer treated with neoadjuvant docetaxel and doxorubicin chemotherapy: paradoxical features of the triple negative breast cancer

Authors: Bhumsuk Keam, Seock-Ah Im, Hee-Jun Kim, Do-Youn Oh, Jee Hyun Kim, Se-Hoon Lee, Eui Kyu Chie, Wonshik Han, Dong-Wan Kim, Woo Kyung Moon, Tae-You Kim, In Ae Park, Dong-Young Noh, Dae Seog Heo, Sung Whan Ha, Yung-Jue Bang

Published in: BMC Cancer | Issue 1/2007

Abstract

Background

Prognostic factors in locally advanced breast cancer treated with neoadjuvant chemotherapy differ from those of early breast cancer. The purpose of this study was to identify the clinical significance of potential predictive and prognostic factors in breast cancer patients treated by neoadjuvant chemotherapy.

Methods

A total of 145 stage II and III breast cancer patients received neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this study. We examined the clinical and biological factors (ER, PR, p53, c-erbB2, bcl-2, and Ki-67) by immunohistochemistry. We analyzed clinical outcome and their correlation with clinicopathologic parameters.

Results

Among the clinicopathologic parameters investigated, none of the marker was correlated with response rate (RR) except triple negative phenotype. Patients with triple negative phenotype showed higher RR (83.0% in triple negative vs. 62.2% in non-triple negative, p = 0.012) and pathologic complete RR (17.0% in triple negative vs. 3.1% in non-triple negative, p = 0.005). However, relapse free survival (RFS) and overall survival (OS) were significantly shorter in triple negative breast cancer patients (p < 0.001, p = 0.021, respectively). Low histologic grade, positive hormone receptors, positive bcl-2 and low level of Ki-67 were associated with prolonged RFS. In addition, positive ER and positive bcl-2 were associated with prolonged OS. In our homogeneous patient population, initial clinical stage reflects RFS and OS more precisely than pathologic stage. In multivariate analysis, initial clinical stage was the only significant independent prognostic factor to impact on OS (hazard ratio 3.597, p = 0.044).

Conclusion

Several molecular markers provided useful predictive and prognostic information in stage II and III breast cancer patients treated with neoadjuvant docetaxel/doxorubicin chemotherapy. Triple negative phenotype was associated with shorter survival, even though it was associated with a higher response rate to neoadjuvant chemotherapy.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/7/203/prepub

Title: Prognostic impact of clinicopathologic parameters in stage II/III breast cancer treated with neoadjuvant docetaxel and doxorubicin chemotherapy: paradoxical features of the triple negative breast cancer
Authors: Bhumsuk Keam
Seock-Ah Im
Hee-Jun Kim
Do-Youn Oh
Jee Hyun Kim
Se-Hoon Lee
Eui Kyu Chie
Wonshik Han
Dong-Wan Kim
Woo Kyung Moon
Tae-You Kim
In Ae Park
Dong-Young Noh
Dae Seog Heo
Sung Whan Ha
Yung-Jue Bang
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2007
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/1471-2407-7-203

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Background

Methods

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