Institution: Hospital Barão De Lucena
Purpose: To assess factors associated with Pathologic Complete Response (PCR) in patients with triple negative breast cancer undergoing neoadjuvant chemotherapy in Barão de Lucena Hospital.Methods: Cohort study, based on an analysis of medical records of patients seen in service from March 2010 to December 2014. The study was approved by the Research Ethics Committee (CEP) and was requested waiver of informed consent and clear (WIC). The factors assessed were age, BMI, menopausal status, family history of breast cancer, tumor size, lymphocytic infiltrate peritumoral, lymph node involvement, clinical stage, EGFR, CK5 / 6, Ki-67, early clinical response to the first cycles of chemotherapy and chemotherapy regimen. For data analysis we used the SPSS software, version 17. The evaluation of the factors that influence the occurrence or non-PCR was applied to the chi-square test for independence and Fisher’s exact test where appropriate. Summary of Results:The pathologic complete response rate was 13.4%, similar to data found in the literature 15%. Clinical features, patients with CRP had a lower age than in the group without PCR (mean: 40.0 ± 8.1), BMI lower among 25- 29.9 (mean: 26.3 ± 2.1), and menopausal they had no family history of breast cancer. Tumor characteristics in patients with CRP was found a higher prevalence of patients with clinically positive nodes (75.0%). Still, it is observed that 100% of patients in this group were: staging type III, Grade 3 type, Ki67 greater than or equal to 14, positivity for CK5 / 6, negative for EGFR. The clinical and tumor characteristics showed no statistical difference between the groups with and without PCR. Of the patients who developed PCR majority used the FAC regimen (18.8%) and responded to neoadjuvant chemotherapy in the first four cycles. There was a decrease in the tumor volume (tumor larger than 5 cm before chemotherapy 76.0% and 47.8% after) and lymphnodes (decrease of 76.0% to 61.9%) with significance for the test homogeneity to the lymph nodes (p = 0.010), indicating favorable response of triple negative to chemotherapy. Most patients with CRP did not metastasize in the future follow-up (75.0%), while in the group without PCR prevalence of metastasis was 65.2% of the patients showing the relationship better prognosis in patients that achieve PCR although the homogeneity test did not have significant value in this study (p-value = 0.273).Conclusions: Although some differences found in tumor characteristics of patients with and without PCR homogeneity test was not significant in any of the evaluated factors, indicating that the tumor profile of the two groups of patients are alike. Even in tumors that have not reached PCR was no response to chemotherapy to reduce the tumor volume and lymph nodes metastases, with statistical significance to the latter, in addition, the prevalence of metastases was lower in the group that developed PC.
Keywords: breast cancer, chemotherapy, triple negative, pathological complete responsR, indicating better prognosis.
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