Dados do Trabalho

Título

RESPOSTA PATOLOGICA COMPLETA APOS QUIMIOTERAPIA NEOADJUVANTE EM PACIENTES COM CANCER DE MAMA: ANALISE DE 83 PACIENTES TRATADAS NO SERVIÇO PUBLICO FEDERAL

Título em Inglês

COMPLETE PATHOLOGICAL RESPONSE AFTER NEOADJUVANT CHEMOTHERAPY IN BREAST CANCER PATIENTS: ANALYSIS OF 83 PATIENTS TREATED AT A FEDERAL PUBLIC SERVICE

Introdução

Neoadjuvant chemotherapy is performed before surgical treatment and aims to make a locally advanced tumor operable, provide conservative treatment, demonstrate tumor sensitivity in vivo and evaluate the pathological response (PR) to treatment. PR is an important prognostic factor and several studies have demonstrated a correlation between the biological factors of the tumor and the response rate. Patients with a complete pathological response (CPR) have longer survival compared to those with residual disease.

Objetivos

The main objective was to assess CPR in patients with breast cancer undergoing neoadjuvant chemotherapy. As secondary objectives, we identified the clinical-pathological variables related to CPR and correlated the pathological response in the breast with the axillary response after chemotherapy.

Métodos

Four hundred and forty-four medical records of patients seen in the Mastology sector were reviewed between January 2016 and July 2019. Eighty-three patients were selected, with 361 cases that did not meet the inclusion criteria being excluded. The exclusion criteria were: benign disease, neoadjuvant hormone therapy, neoadjuvant radiation therapy, trastuzumab associated with chemotherapy, upfront surgery and patients who did not receive surgical treatment after chemotherapy. The variables analyzed were: age, tumor size, axillary involvement, histological type and grade, molecular subtype and CPR.

Resultados

Most patients were over 50 years old (62%) and had tumors larger than 5 cm (75%). Fifty (60%) had initial axillary involvement. Of the 83 patients, 64 (77%) did not obtain a pathological response in the breast and armpit. Two (3%) showed a response only in the breast. CPR was observed in 17 patients (20%) and almost half of them were under 50 years old (47%). Moderately differentiated (grade 2) and undifferentiated (grade 3) tumors, accounted for 96% of cases and had a higher rate of CPR than grade 1 tumors. In HER2 positive subtypes, CPR occurred in 36% and in negative triples in 22% , being higher than in luminous subtypes A and B (15% and 17%, respectively).

Conclusões

The histological grade and molecular subtypes correlate with the pathological response to neoadjuvant chemotherapy. More undifferentiated tumors and the triple negative and HER 2 positive molecular subtypes have a higher CPR rate. Despite the small sample, the results of this study were similar to those in the medical literature. A greater number of cases is necessary to corroborate the data obtained, as well as a longer follow-up time to demonstrate the relationship between CPR and survival.

Palavras Chave

Breast cancer. Pathological complete response. Neoadjuvant chemotherapy. Surgery. Molecular subtype.

Área

TUMOR CELL, MOLECULAR BIOLOGY, PREDICTIVE AND PROGNOSTIC FACTORS - Tumor cell, molecular biology, predictive and prognostic factors – other