5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement41st Annual Miami Breast Cancer Conference® - Abstracts
Volume 38
Issue 4
Pages: 8-9

Background

Neoadjuvant therapy can downstage the axilla, reducing the need for an axillary dissection. In addition, obtaining a complete pathologic response in the axilla is associated with a better 10-year overall survival. Our institution previously reported axillary response rates in patients with hormone receptor–positive, HER2-negative (HR+/HER2–), clinically node-positive breast cancer undergoing neoadjuvant therapy in a small cohort of patients. The cohort, however, was too small for a deeper dive into potential predictors of response. In this current study, we sought to expand this cohort of patients until 2022—almost doubling the number of patients—to better evaluate for potential predictors of response.

Methods

A single-institution, retrospective cohort study included patients with HR+/HER2–, clinically node-positive breast cancer treated with neoadjuvant therapy, either endocrine or chemotherapy, between January 2011 and December 2022.
The data were divided into patients with confirmed partial response (cPR) and no cPR in the axilla. The primary outcome was to identify demographic and clinicopathologic parameters that corelated to cPR in the axilla. The χ2 test or Fisher exact test for categorical variables and the t test for continuous variables were performed. Logistic regression analysis was performed to assess clinical factors associated with the number of complications.

Results

The Demographic Profile of Patients, Tumor Characteristics, and Treatment

The Demographic Profile of Patients, Tumor Characteristics, and Treatment

In all, 200 patients with breast cancer met the inclusion criteria. They were divided into 2 cohorts: patients with an axillary cPR rate of 12% (n = 24) and no axillary cPR 88% (n = 176). The mean (SD) age was 52.17 (11.5) years. The demographic profile of patients, tumor characteristics, and treatment are described in the Table. Among patients who underwent genomic profiling (n = 25), 76% (n = 19) had MammaPrint done, whereas 24% (n = 6) had Oncotype testing. MammaPrint was performed in2 patients found to have cPR in the axilla; it was high risk in both patients. For patients who underwent chemotherapy, approximately 13.6% achieved axillary cPR. For patients who underwent hormone therapy, approximately 6.5 % achieved axillary cPR (P = .29). A significantly higher axillary cPR rate was identified in patients with clinical stage II disease at diagnosis (14/70 patients [20%]) compared with those having stage III disease (10/128 patients [7.8%]; P = .013). Patients with axillary cPR had fewer lymph nodes removed at the time of surgery compared with those having no cPR (8 vs 16 lymph nodes; P = .001).

Conclusions

An axillary cPR in patients with HR+/HER2–, clinically node-positive breast cancer was higher in those with a lower clinical stage (stage II). Patients with a cPR were able to avoid an axillary dissection. A larger cohort of patients is necessary to define more possible predictors of axillary response rate to neoadjuvant therapy.

Articles in this issue

1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
3 Gender Disparities in the  National Institutes of Health  Funding for Breast Cancer
3 Gender Disparities in the National Institutes of Health Funding for Breast Cancer
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast  Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
13 The Cause and Eradication of Breast Cancer
13 The Cause and Eradication of Breast Cancer
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
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