Archives

  • 2019-07
  • 2019-10
  • 2019-11
  • 2020-03
  • 2020-07
  • 2020-08
  • 2021-03
  • br ously reported the prognosis was

    2020-03-24


    ously reported, the prognosis was worse when the molec-ular subtype of breast cancer showed triple negativity or had a high Ki67 proliferative index.
    The mechanism of changed biomarkers after NAC in breast cancer has not been completely proved, yet. However, this finding may be explained as necrosis of tumor KX2-391 by chemotherapeutic effect, if the sampling error in needle biopsy before treatment is excluded.22,23 Balko et al suggested that the residual tumor burden could obtain a resistance to chemotherapy after NAC, therefore the later status of biomarkers would be impact in disease prognosis.24 Another theory is that intratumoral heterogeneity provides a chance to change the level of protein expressions which leads changes of clonal characteristics.25
    It is well known that the prognosis of hormone receptor-positive breast cancers is better than that of HER2 (รพ) breast cancer or TNBC. Conversely, it is also well known
    that the therapeutic response to chemotherapy is better in HER2 (รพ) and TNBC. However, only a few studies have
    evaluated the oncologic results of locally advanced, hor-mone receptor-negative breast cancer that needs NAC.26,27
    The current study showed that the risk of local recurrence and distant metastasis in ER ( ) breast cancers significantly higher both before and after NAC, even if the overall sur-vival was not high. This implies that the absence of ER should be considered as a prognostic factor in tailored neoadjuvant treatment according to the status of molecu-lar subtypes in breast cancer.
    This study has several limitations. First, number of pa-tients enrolled was small. However, we included only pre-cise data, excluding patients with ambiguous results or showing pCR after NAC and a mean follow-up of 7 years. It is conceded as a result of observations over a sufficiently long period. Second, this study was conducted at a single center. Further multicenter studies are required.
    Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
    + MODEL
    Figure 5 Association between oncologic outcomes and the Ki67 proliferative index in patients receiving undergoing chemo-therapy. Local recurrence (A, D); distant metastasis (B, E); and overall survival (C, F) according to the Ki67 proliferative index before and after neoadjuvant chemotherapy.
    Table 5 Associations between oncologic outcomes and change of immunohistochemical stain results before and after neo-adjuvant chemotherapy.
    5. Conclusion
    Tailored neoadjuvant treatment should be determined on the basis of the molecular subtypes of breast cancer. Because the
    absence of ER in breast cancer KX2-391 before and after NAC is a sig-nificant prognostic factor for local recurrence and distant metastasis, the absence of ER should be considered as important factor when the treatment strategy is determined.
    Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
    + MODEL
    Absence of ER in breast cancer 9
    Conflict of interest
    The authors declare that they have no conflict of interests.
    Acknowledgements
    This work was supported by the National Research Foun-dation of Korea (NRF) grant funded by the Korea govern-ment (2014R1A5A2009242, 2017R1C1B5076186) and by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1420040). And this research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), fun-ded by the Ministry of Health & Welfare, Republic of Korea (HI17C1142). This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2019R1A2C1006264).