Authors: Izquierdo M, Tresserra F, Rodriguez I, Garcia M, Baulies S, Ara C, Fabregas R.
Purpose: The response to neoadjuvant therapy correlates with prognosis. Being able to predict the response before performing the neoadjuvant treatment with Ki 67, HER2 and Hormone Receptors (RH) of the tumour [estrogens' receptor (ER) and progesterone receptor (PR)] and the patient's body mass index (BMI) may help to define it.
Material and Methods: We studied the response to neoadjuvant treatment in 170 patients with breast cancer using the Miller and Payne Grading System (MPG). Pathological response was considered with a MPG 4,5. Before the neoadjuvant treatment, Ki67, HER2, RH and BMI were studied and related to the response to neoadjuvant treatment by logistic regression.
Results: The study of factors was: Ki67 <14 in 56 (32.9%) patients and Ki 67> 14 in 114 (67.1%) patients; RE negative in 40 (23.5%) patients and positive ER in 130 (76.5%) patients; Negative RP in 75 (44.1%) patients and positive RP in 95 (55’8%) patients; HER2 negative in 118 (69.4%) patients and HER2 positive in 52 (30.6%) patients.
MPG 4-5 was obtained in 86 patients (50'6%) with a mean age of 48'4 + 8'8 years. MPG 1-2-3 was obtained in 84 patients (49.4%) with a mean age of 48.82 + 9.7 years. The mean BMI in patients with MPG 1-2-3 was 23.35 + 4.64, and in patients with MPG 4-5 it was 25.24 + 4.25 (p = ns). MPG 4-5 was obtained in 22 (26%) tumours with Ki67 <14 and 64 (74%) tumours with Ki67> 14 (p <0.05); in 24 (28%) ER negative tumours and 62 (72%) ER positive tumours (p = ns); in 46 (53%) RP negative tumours and 40 (47%) RP positive. (P <0.05)
We grouped the 170 patients into eight subgroups of patients according to the status of Ki67, RP and HER2 assessing MPG 4-5. The MPG 4-5 in Ki67 <14 RP (-) HER2 (-) was obtained in 3 (27.3%) cases and was not obtained in 8 (72.7%), Ki67> 14 RP (-) HER2 (+) was obtained in 5 (83.3%) cases and was not obtained in 1 (10.7%) cases. (P <0.05). In the other subgroups there were no significant differences
Conclusion: Ki67, HER2 and RP predict the response to neoadjuvant chemotherapy. BMI does not affect the response to neoadjuvant chemotherapy.
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