Objective: To assess the response of neoadjuvant chemotherapy and its influencing factors in the breast cancer patients.
Methods: 171 patients with stage II or operable stage III breast cancers were treated with neoadjuvant chemotherapy before surgery between January 2004 and May 2005. Of these, 160 received and completed > or =3 cycles of neoadjuvant chemotherapy, 11 received only 2 cycles. The regimens of neoadjuvant chemotherapy were: CEF (CTX, Epirubicin, 5-Fu); NE (Navelbine, Epirubicin); TEC (Taxotere, Epirubicin, CTX). Response of neoadjuvant chemotherapy was evaluated in all patients by palpation, ultrasonography and pathological methods.
Results: Complete response rate and clinical objective response rate determined by clinical palpation (cCR, cOR), ultrasonography (sCR, sOR) and pathology (pCR) was 18.7% and 88.3%; 4.1% and 74.9%; 15.2%, respectively. The correspondence rate of the pCR with cCR and sCR was 43.8% and 42.9%, respectively. It was showed by univariate analysis that patient whose tumor was < or =3 cm in diameter, or ER negative or grade 3 were more likely to achieve a pCR than those whose tumor was >3 cm, or ER positive or grade 1. Logistic regression analysis showed that only tumor size was the significant predictive factor for response to neoadjuvant chemotherapy in patients with primary breast cancer.
Conclusion: Patient with small, or ER negative or grade 3 tumor may have better pathological response to neoadjuvant chemotherapy, particularly, the tumor size is more predictive of pCR. Palpation or ultrasonography may have a tendency either to under- or to overestimate pCR. Breast neoplasms/drug therapy;