Identifying factors predicting the response to neoadjuvant chemotherapy in breast carcinoma

Neoadjuvant chemotherapy (NAC) improves outcomes of patients with non-metastatic breast carcinomas (BC). This statement is particularly true once a complete pathological response (pCR) to chemotherapy is achieved. We aimed through this study to identify the potential predictors of pCR in BC and to investigate its prognostic impact on both overall survival (OS) and progression-free survival (PFS). A total of 97 patients with non-metastatic breast carcinoma was enrolled in our study. Only 11 patients among them reached pCR (11.3%). Oestrogen and progesterone receptors negative BC as well as HER2 overexpressed molecular subtype exhibited higher pCR rates (p=0.005, p=0.01 and p<0.001 respectively). Furthermore, the use of sequential NAC regimen and of neoadjuvant trastuzumab were significantly predictive of pCR (p=0.03 and 0.02 respectively). Mean OS and PFS were 84 months and 56 months, respectively. On univariate analysis, patients who had achieved pCR showed longer OS and PFS, although the association was statistically significant only for PFS (p = 0.03). Thus, pathologist’s role seems to be crucial in predicting long-term outcomes through assessing the quality of pathological response to NAC. Further researches should focus on optimizing treatment regimens to increase pCR rates and improve outcomes.