Prognosis Varies Among Women Who Have Incomplete Response to Neoadjuvant Chemotherapy

Date of presentation: September 14, 2012

Among women who still have detectable cancer after neoadjuvant (before surgery) chemotherapy for triple-negative breast cancer, prognosis depends in part on how much cancer remains. Women with only a small amount of residual cancer tend to have a favorable prognosis. These results were presented at the 2012 Breast Cancer Symposium.

Neoadjuvant chemotherapy refers to chemotherapy that is given prior to surgery. This approach can make surgery easier to perform by shrinking or eliminating cancer prior to surgery. Neoadjuvant chemotherapy also provides information about how the cancer responds to chemotherapy.

Women who have a complete response to neoadjuvant chemotherapy (a complete elimination of detectable cancer) tend to have better outcomes than women who do not have a complete response. Outcomes among women who do not have a complete response, however, may vary depending on how much cancer remains. Women with only a small amount of residual cancer, for example, may have a favorable prognosis.

To assess how the amount of residual cancer affects prognosis, researchers in Germany conducted a study among more than 500 women with triple-negative breast cancer. The study was restricted to women who had received neoadjuvant chemotherapy but had not had a complete response (in other words, all of the study participants still had detectable cancer after completion of neoadjuvant chemotherapy).

  • Women with smaller amounts of residual cancer had better overall and disease-free survival than women with larger amounts of residual cancer.
  • Among women with the smallest amount of residual cancer (T1a), two-year overall survival was 88%.

A limitation of the study was that the researchers were not able to account for all of the factors that may affect prognosis, such as whether the cancer had spread to the lymph nodes. The study suggests, however, that prognosis varies among women with triple-negative breast cancer that does not respond completely to neoadjuvant chemotherapy. Women with only a small amount of remaining cancer tend to have favorable outcomes.

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Kern P, Badiian M, Minckwitz et al. Triple-negative breast cancer (TNBC) and residual disease (non-pCR): Does size matter? Presented at the 2012 Breast Cancer Symposium. September 13-15, 2012. San Francisco, CA. Abstract 106.[ Full text available here ]

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