|Table of Contents|

Analysis of factors affecting the efficacy and prognosis of neoadjuvant chemotherapy in patients with HER-2-low-positive breast cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 20
Page:
3784-3790
Research Field:
Publishing date:

Info

Title:
Analysis of factors affecting the efficacy and prognosis of neoadjuvant chemotherapy in patients with HER-2-low-positive breast cancer
Author(s):
ZHENG Lu1; 2; TANG Tong2; WANG Zhitao3; WANG Benzhong1
1Department of Breast Surgery,the First Affiliated Hospital of Anhui Medical University,Anhui Hefei 230022,China;2Department of General Surgery;3Department of Hematology,the Second Affiliated Hospital of Anhui Medical University,Anhui Hefei 230601,China.
Keywords:
breast cancer; low expression of human epidermal growth factor receptor 2; neoadjuvant chemotherapy; prognostic factors
PACS:
R737.9
DOI:
10.3969/j.issn.1672-4992.2023.20.012
Abstract:
Objective:To study the effect of low HER-2 protein expression on neoadjuvant chemotherapy in breast cancer.Additionally,the factors associated with treatment efficacy and prognosis were examined in greater detail.Method:Data from 213 patients with HER-2 negative breast cancer who underwent neoadjuvant chemotherapy in our hospital between January 2016 and December 2022 were gathered for this study.The relationship between different levels of HER-2 protein expression and the efficacy and pathological characteristics of neoadjuvant chemotherapy was investigated by test and variance analyses.A non-conditional logistic regression model was used to examine factors impacting the pathologic complete response (pCR) with low HER-2 expression.The consistency of HER-2 status before and after neoadjuvant chemotherapy was assessed by Cohen's kappa coefficient (κ).The Kaplan-Meier method was used to generate the survival curve,and an unconditional logistic regression model was used to analyze factors affecting the overall survival (OS) with low HER-2 expression.Results:The study involved 213 patients,with 170 in the low HER-2 expression group and 43 in the HER-2 0 expression group.The results showed that HER-2-low-positive breast cancer had a higher incidence axillary of supraclavicular and infraclavicular lymph node metastasis(P=0.002),low histological grade (P=0.045),low vascular invasion (P=0.015),and a higher proportion of ER/PR/HR(P<0.001),but no significant differences in age,BMI,menstrual status,pathological type,T stage,TNM stage and Ki-67 were observed (P＞0.05).After neoadjuvant chemotherapy,the pCR rates of HER-2 protein expression IHC 0,IHC 1+ and IHC 2+/ISH- decreased sequentially,with 48.8%,40.7% and 23.8%,the difference among the three was statistical significance (P=0.009).In the total population,the pCR rate of HER-2 low expression group was lower than that of 0 expression group,with no significant difference (P=0.082).The consistency of tumor HER-2 status before and after neoadjuvant chemotherapy was moderate (κ＝0.494).Logistic regression analysis indicated that the status of upper and lower clavicular lymph nodes was an independent factor affecting PCR with low HER-2 expression (P＜0.05).The OS analysis of HER-2 low expression result showed that tumor size,pathological stage and pCR were the factors affecting the prognosis of breast cancer patients (P<0.05).Conclusion:Breast cancer patients with low HER-2 expression exhibit distinct clinicopathological characteristics.The status of upper and lower clavicular lymph nodes was identified as an independent factor influencing the pCR rate after neoadjuvant chemotherapy for these patients (P＜0.05).Additionally,lymph node metastasis,tumor size,pathological stage and pCR were found to be significant factors affecting the survival of breast cancer patients.

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Memo

Memo:
National Natural Science Foundation of China(No.82200225);国家自然科学基金青年项目（编号：82200225）;吴阶平医学基金会临床科研专项资助基金(编号:320.6750.2021-10-25);安徽省高等教育人文社会科学重点项目（编号：SK2021A0167）;安徽医科大学校科研基金资助项目(编号：2018xkj038）
Last Update: 1900-01-01