|
KMID : 1134120090120010041
|
|
Journal of Breast Cancer
2009 Volume.12 No. 1 p.41 ~ p.46
|
|
|
The Changes of the Histologic and Biologic Markers Induced by Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer
|
|
Choi Un-Jong
Lee Kwang-Man
|
|
|
Abstract
|
|
|
Purpose:Neoadjuvant chemotherapy (NAC) has become the standard treatment for locally advanced breast cancer. The postoperatively adjuvant systemic treatment is based on the status of the histological and biological markers of either the pre-NAC or the post-NAC. There have been several reports that have demonstrated the changes of the histological and biological markers after NAC. The aim of this study is to investigate the effects of NAC on the expression
of the histological and biological markers of breast cancer.
Methods:We analyzed the paired pre- and post-NAC tumor specimens from 37 patients with stage IIIA, IIIB or IIIC breast cancer. All the patients received 2 to 6 cycles of anthracycline- containing NAC. Over 6 pieces of pre-NAC tumor specimens were taken by 14 G core needle from multiple sites of a tumor, and the post-NAC specimens were taken at the
time of the operation. The histologic grade and immunohistochemical expression of estrogen receptor (ER), progesterone
receptor (PR), c-erbB2, p53, Ki67, CD31 and pglycoprotein were analyzed in the paired pre- and post-NAC tumor specimens from 37 patients.
Results:Twenty five patients (67.6%) revealed significant changes of more than one marker. The markers that showed changes of more than two grades were as follows; histologic grade in 1, ER in 4, PR in 9, c-erbB2 in 4, p53 in 1, Ki67 in 4, CD31 in 9 and pglycoprotein in 5 patients. In 12 patients (32.4%), significant changes were found in the markers that can influence the decision-making for adjuvant treatment (i.e. ER, PR and cerbB2). The ER/PR status changed from positive to negative in 4 patients and c-erbB2 was changed from positive to negative in 3 patients. Among those patients, the strategy of adjuvant treatment was adjusted according to the changes.
Conclusion:The specimens for the histologic and biologic markers of a tumor should be taken before NAC because NAC can have an influence on the expression of the prognostic markers of locally advanced breast cancers, and this may subsequently influence predicting the prognosis and making the decision for adjuvant systemic treatment.
|
|
|
KEYWORD
|
|
|
Breast cancer, Markers, Neoadjuvant chemotherapy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|