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pCR rates in patients with bilateral breast cancer after neoadjuvant anthracycline-taxane based-chemotherapy - A retrospective pooled analysis of individual patients data of four German neoadjuvant trials

Mattea Reinisch, Jens Huober, Gunter Von Minckwitz, Jens-Uwe Blohmer, Carsten Denkert, Claus Hanusch, Christian Jackisch, Sherko Kümmel, Andreas Schneeweiss, Kerstin Rhiem, Bianca Lederer, Michael Untch, Valentina Nekljudova V & Sibylle Loibl

abstract

PURPOSE
Patients with bilateral breast cancer (BBC) are usually excluded from participating in clinical trials and little is known about the response and outcome of BBC to neoadjuvant chemotherapy compared to unilateral BC (UBC).

METHODS
We prospectively captured the information on patients with BBC in our database treated within four neoadjuvant chemotherapy trials and collected retrospectively the rate of pathological complete response (pCR) defined as ypT0 ypN0, ypT0/is ypN0, ypT0 ypNX, clinical and histologic parameters. Synchronous carcinoma in the contralateral breast was considered as the non-indicator lesion. Patients with UBC only treated within the same neoadjuvant trials performed the control group.

RESULTS
From the 6727 patients treated within 4 German neoadjuvant trials 119 (1.8%) patients have been identified with the diagnosis of BBC. The pCR rate (ypT0 ypN0) was 12.6% in the non-indicator lesion group versus 10.9% the indicator lesion group versus 20.9% for patients with unilateral disease (p = 0.003). There were more advanced tumor stages and positive axillary lymph nodes in the indicator lesion than in the nonindicator lesion or in UBC. In 52.5% the molecular subtype was identical between indicator and non-indicator lesion with more triple negative and HER2 positive BC in the group of UBC. The disease free survival rate (DFS) was 25.8% for patients with UBC versus 39.6% for patients with BBC.

CONCLUSION
The selection for the indicator lesion was based on tumor size, nodal status and inclusion criteria. Patients with BBC patients had a lower pCR rate and a lower DFS.
   
citation Reinisch M, Huober J, von Minckwitz G, Blohmer J U, Denkert C, Hanusch C, Jackisch C, Kümmel S, Schneeweiss A, Rhiem K, Lederer B, Untch M, Nekljudova V V, Loibl S. pCR rates in patients with bilateral breast cancer after neoadjuvant anthracycline-taxane based-chemotherapy - A retrospective pooled analysis of individual patients data of four German neoadjuvant trials. Breast 2017; 32:73-78.
   
type journal paper/review (English)
date of publishing 05-01-2017
journal title Breast (32)
ISSN electronic 1532-3080
pages 73-78
PubMed 28063331
DOI 10.1016/j.breast.2016.12.020