The Efficacy of Neoadjuvant Chemotherapy for HER-2-Positive Locally Advanced Breast Cancer and Survival Analysis

Abstract

To provide reference data, we retrospectively investigated the effects of neoadjuvant chemotherapy (NAC) on 119 patients with HER-2+ locally advanced breast cancer, treated from November 2010 to July 2016, with respect to influencing factors and survival. They were divided into the pathological complete response (pCR; n=15; 12.6%) and non-pCR (n=104; 87.4%) groups. We used Χ2 and logistic tests to the analyze effect and influencing factors. Survival rate was analyzed by the Kaplan-Meier method and Log-rank test. We lost 12 patients (including 1 pCR patient) and followed 107 patients, of whom 31 (all in the non-pCR group) had local recurrences or distant metastasis. The two groups significantly differed in 3-year disease-free survival (pCR group: 100%; non-pCR group: 59.0%; P=0.039); pCR was significantly affected by histological grade, PR status, Ki67 index, primary tumor size, clinical staging, and number of trastuzumab cycles. The model was tested, and the difference was statistically significant (Χ2 = 31.938, P=0.032). Patients with HER-2+ locally advanced breast cancer with pCR responses to NAC have improved prognoses. Patients without pCR have increased risk for relapse. The use of a combination of NAC, such as trastuzumab and chemotherapy, and more cycles should be considered to increase the likelihood of pCR.