EVALUATION OF RESPONSE TO NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH BREAST CANCER

BACKGROUND: Chemotherapy is the first treatment of choice in locally advanced breast cancer and there is a need for predictive factors to determine the response to chemotherapy. In this study, the relation between pathologic tumor response and axillary metastases and other histopathologic parameters after neoadjuvant chemotherapy was evaluated. MATERIAL and METHODS: Breast cancer patients treated with surgery after neoadjuvant chemotherapy were included to the study. Surgery was performed when a decrease in clinical tumor size, axillary metastases or skin edema was obtained in patients. Patients were grouped according to pathologic tumor size, presence and number of axillary metastases, age, tumor grade, estrogen and progesteron receptor status, p53 and c-erbB-2 status after chemotherapy. RESULTS: Seventy-four patients treated with anthracycline containing protocols were evaluated. Pathologic complete tumor response was detected in seven patients (9.5%) whereas complete axillary response was present in eight patients (10.8%) after chemotherapy. The number of metastatic axillary lymph nodes were found to be increased when the size of the residual tumor was large (p<0.001). Complete axillary response rate was higher in patients with complete tumor response (p=0.024). In addition, there was a statistically marginally significant relation between tumor response and c-erbB-2 positivity (p=0.05). CONCLUSIONS: There is a direct relation between tumor response and the response of axillary metastases after neoadjuvant chemotherapy.