Factors Affecting Treatment Response in Patients With Locally Advanced Breast Cancer Receiving Neoadjuvant Treatment
Abstract
Amaç: Meme kanseri kadınlarda en sık görülen kanser olup kadınlarda kansere bağlı ölümlerin ikinci en sık nedenidir. Meme kanseri tedavisinde kemoterapi, radyoterapi, hormonoterapi ve hedefe yönelik tedaviler kullanılmaktadır. Bu çalışmada neoadjuvan kemoterapi alan meme kanserli hastalarda tedavi yanıtını etkileyen faktörlerin incelenmesi amaçlandı. Materyal ve Metod: Çalışmaya 2018-2021 yılları arasında Van Yüzüncü Yıl Üniversitesi Dursun Odabaşı Tıp Merkezi Medikal Onkoloji Kliniğine başvuran ve meme kanseri tanısı ile takibi ve tedavisi yapılan henüz opere olmamış 18 yaş üstü hastalar retrospektif olarak alındı. İstatistiksel analiz için Statistical Package for Social Sciences 22.0 for Windows software (Armonk NY, IBM Corp. 2013) kullanıldı. Bulgular: Çalışmaya tümü kadın olan 57 hasta alındı. Hastalarda medyan yaş 46 idi. Östrojen reseptörü pozitifliği medyan değeri %80, progesteron reseptörü pozitifliği medyan değeri %30 olarak bulundu. 21 hastada (%36,8) HER-2neu ekspresyonu pozitif saptandı. Tanı evresi 10 hasta (%17,5) grade 1, 31 hasta (%54,4) grade 2, 16 hasta (%28,1) grade 3 olarak saptandı. Klinik açıdan Evre 1'de 7 hasta (%12,3), Evre 2'de 42 hasta (%73,7), Evre 3'de ise 8 hasta (%14,0) bulunmaktaydı. Başvuru sırasında 54 hasta (%94,7) İDC tanılıydı, 28 hasta (%49,1) premenapozal dönemde iken 29 hasta (50,9) postmenapozal dönemde idi. Hastaların 8 (% 24,6)'inde ailede meme kanseri öyküsü vardı. Perinöral invazyon 4 hastada (%7,0), lenfovasküler invazyon 16 hastada (%21,1) pozitif olarak saptandı. 12 hastada (%21) patolojik tam yanıt saptandı. Rekürrenssiz sağkalım açısından tam yanıt alınanlar ile tam yanıt alınamayanlar arasında anlamlı fark saptanmadı. Sonuç: Tümör boyutu meme kanserinin neodajuvan tedavisinde tam yanıtı etkileyen önemli bir faktör olarak bulundu. Hormon reseptör pozitifliği, tümörde yüksek grade, lenf nodu tutulumu, Kİ-67 indeksi değeri ve HER-2 pozitifliği çalışmamızda neoadjuvan tedaviye yanıtı etkileyen faktörlerden biri olarak saptanmadı.
Purpose: Breast cancer is the most common cancer in women and the second most common cause of cancer-related death in women. Chemotherapy, radiotherapy, hormone therapy and targeted therapies are used in the treatment of breast cancer. In this study, it was aimed to examine the factors affecting the treatment response in breast cancer patients receiving neoadjuvant chemotherapy. Materials and Methods: Patients over the age of 18 who applied to Van Yüzüncü Yıl University Dursun Odabaşı Medical Center Medical Oncology Clinic between 2018 and 2021 and were followed up and treated with the diagnosis of breast cancer, who were not operated yet, were included in the study retrospectively. Statistical Package for Social Sciences 22.0 for Windows software (Armonk NY, IBM Corp. 2013) was used for statistical analysis. Results: 57 patients, all of whom were women, were included in the study. The median age of the patients was 46 years. The median value of estrogen receptor positivity was 80%, and the median value of progesterone receptor positivity was 30%. HER-2neu expression was positive in 21 patients (36.8%). The diagnosis stage was determined as grade 1 in 10 patients (17.5%), grade 2 in 31 patients (54.4%), and grade 3 in 16 patients (28.1%). Clinically, there were 7 patients (12.3%) in Stage 1, 42 patients (73.7%) in Stage 2, and 8 patients (14.0%) in Stage 3. At the time of admission, 54 patients (94.7%) were diagnosed with IDC, 28 patients (49.1%) were in the premenopausal period, while 29 patients (50.9%) were in the postmenopausal period. Eight patients (24.6%) had a family history of breast cancer. Perineural invasion was positive in 4 patients (7.0%), and lymphovascular invasion was positive in 16 patients (21.1%). Pathological complete response was detected in 12 patients (21%). In terms of recurrence-free survival, there was no significant difference between those with a complete response and those without a complete response. Conclusion: Tumor size was found to be an important factor affecting the complete response in the neoadjuvant treatment of breast cancer. Hormone receptor positivity, high grade of the tumor, lymph node involvement, KI-67 index value and HER-2 positivity were not found as one of the factors affecting the response to neoadjuvant therapy in our study.
Purpose: Breast cancer is the most common cancer in women and the second most common cause of cancer-related death in women. Chemotherapy, radiotherapy, hormone therapy and targeted therapies are used in the treatment of breast cancer. In this study, it was aimed to examine the factors affecting the treatment response in breast cancer patients receiving neoadjuvant chemotherapy. Materials and Methods: Patients over the age of 18 who applied to Van Yüzüncü Yıl University Dursun Odabaşı Medical Center Medical Oncology Clinic between 2018 and 2021 and were followed up and treated with the diagnosis of breast cancer, who were not operated yet, were included in the study retrospectively. Statistical Package for Social Sciences 22.0 for Windows software (Armonk NY, IBM Corp. 2013) was used for statistical analysis. Results: 57 patients, all of whom were women, were included in the study. The median age of the patients was 46 years. The median value of estrogen receptor positivity was 80%, and the median value of progesterone receptor positivity was 30%. HER-2neu expression was positive in 21 patients (36.8%). The diagnosis stage was determined as grade 1 in 10 patients (17.5%), grade 2 in 31 patients (54.4%), and grade 3 in 16 patients (28.1%). Clinically, there were 7 patients (12.3%) in Stage 1, 42 patients (73.7%) in Stage 2, and 8 patients (14.0%) in Stage 3. At the time of admission, 54 patients (94.7%) were diagnosed with IDC, 28 patients (49.1%) were in the premenopausal period, while 29 patients (50.9%) were in the postmenopausal period. Eight patients (24.6%) had a family history of breast cancer. Perineural invasion was positive in 4 patients (7.0%), and lymphovascular invasion was positive in 16 patients (21.1%). Pathological complete response was detected in 12 patients (21%). In terms of recurrence-free survival, there was no significant difference between those with a complete response and those without a complete response. Conclusion: Tumor size was found to be an important factor affecting the complete response in the neoadjuvant treatment of breast cancer. Hormone receptor positivity, high grade of the tumor, lymph node involvement, KI-67 index value and HER-2 positivity were not found as one of the factors affecting the response to neoadjuvant therapy in our study.
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İç Hastalıkları, Meme hastalıkları, Meme neoplazmları, Neoadjuvan tedavi, Neoplazmlar, Sağkalım, Tedavi, İlaç tedavisi, Internal diseases, Breast diseases, Breast neoplasms, Neoadjuvant therapy, Neoplasms, Survival, Treatment, Drug therapy
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