Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers
Human epidermal growth factor receptor 2 (HER2)-enriched breast cancers (BC) present the highest rates of pathological response to primary systemic therapy (PST), but they are also the ones that tend to be larger at diagnosis, with microcalcifications and, often, with axillary involvement. If we do...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/10/2757 |
| _version_ | 1797600699581726720 |
|---|---|
| author | Jose Ignacio Sánchez-Méndez Mónica Horstmann Nieves Méndez Laura Frías Elisa Moreno Laura Yébenes Mᵃ José Roca Alicia Hernández Covadonga Martí |
| author_facet | Jose Ignacio Sánchez-Méndez Mónica Horstmann Nieves Méndez Laura Frías Elisa Moreno Laura Yébenes Mᵃ José Roca Alicia Hernández Covadonga Martí |
| author_sort | Jose Ignacio Sánchez-Méndez |
| collection | DOAJ |
| description | Human epidermal growth factor receptor 2 (HER2)-enriched breast cancers (BC) present the highest rates of pathological response to primary systemic therapy (PST), but they are also the ones that tend to be larger at diagnosis, with microcalcifications and, often, with axillary involvement. If we do not have a reliable method to predict the degree of response, we may not be able to transfer the benefits of PST to surgery. The post-PST surgery planning is guided by the findings in the magnetic resonance imaging (MRI), whose predictive capacity, although high, is far from optimal. Thus, it seems interesting to find other variables to improve it. A retrospective observational study including women with HER2 BC treated with PST and further surgery was conducted. Information regarding clinical, radiological, and histopathological variables was gathered from a total of 132 patients included. Radiological complete response (rCR) was achieved in 65.9% of the sample, and pathological complete response (pCR), according to Miller and Payne criteria, in 58.3% of cases. A higher Ki67 value, the absence of Hormonal Receptors expression, and an rCR was significantly related to a pCR finding. This information impacts directly in surgery planning, as it permits adjustment of the breast resection volume. |
| first_indexed | 2024-03-11T03:51:34Z |
| format | Article |
| id | doaj.art-490ff800cfc641e7becdc332b0c216a1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T03:51:34Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-490ff800cfc641e7becdc332b0c216a12023-11-18T00:48:29ZengMDPI AGCancers2072-66942023-05-011510275710.3390/cancers15102757Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast CancersJose Ignacio Sánchez-Méndez0Mónica Horstmann1Nieves Méndez2Laura Frías3Elisa Moreno4Laura Yébenes5Mᵃ José Roca6Alicia Hernández7Covadonga Martí8Breast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, SpainBreast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainBreast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainBreast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), 28029 Madrid, SpainBreast Unit, Radiology Department, University Hospital La Paz, 28046 Madrid, SpainBreast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainBreast Unit, Obstetrics & Gynecology Department, University Hospital La Paz, 28046 Madrid, SpainHuman epidermal growth factor receptor 2 (HER2)-enriched breast cancers (BC) present the highest rates of pathological response to primary systemic therapy (PST), but they are also the ones that tend to be larger at diagnosis, with microcalcifications and, often, with axillary involvement. If we do not have a reliable method to predict the degree of response, we may not be able to transfer the benefits of PST to surgery. The post-PST surgery planning is guided by the findings in the magnetic resonance imaging (MRI), whose predictive capacity, although high, is far from optimal. Thus, it seems interesting to find other variables to improve it. A retrospective observational study including women with HER2 BC treated with PST and further surgery was conducted. Information regarding clinical, radiological, and histopathological variables was gathered from a total of 132 patients included. Radiological complete response (rCR) was achieved in 65.9% of the sample, and pathological complete response (pCR), according to Miller and Payne criteria, in 58.3% of cases. A higher Ki67 value, the absence of Hormonal Receptors expression, and an rCR was significantly related to a pCR finding. This information impacts directly in surgery planning, as it permits adjustment of the breast resection volume.https://www.mdpi.com/2072-6694/15/10/2757breast cancerHER2 subtypeprimary systemic therapypredictors of responsepathological complete responsemagnetic resonance imaging |
| spellingShingle | Jose Ignacio Sánchez-Méndez Mónica Horstmann Nieves Méndez Laura Frías Elisa Moreno Laura Yébenes Mᵃ José Roca Alicia Hernández Covadonga Martí Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers Cancers breast cancer HER2 subtype primary systemic therapy predictors of response pathological complete response magnetic resonance imaging |
| title | Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers |
| title_full | Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers |
| title_fullStr | Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers |
| title_full_unstemmed | Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers |
| title_short | Surgical Interest of an Accurate Real-World Prediction of Primary Systemic Therapy Response in HER2 Breast Cancers |
| title_sort | surgical interest of an accurate real world prediction of primary systemic therapy response in her2 breast cancers |
| topic | breast cancer HER2 subtype primary systemic therapy predictors of response pathological complete response magnetic resonance imaging |
| url | https://www.mdpi.com/2072-6694/15/10/2757 |
| work_keys_str_mv | AT joseignaciosanchezmendez surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT monicahorstmann surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT nievesmendez surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT laurafrias surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT elisamoreno surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT laurayebenes surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT majoseroca surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT aliciahernandez surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers AT covadongamarti surgicalinterestofanaccuraterealworldpredictionofprimarysystemictherapyresponseinher2breastcancers |