Pathological response analysis of breast cancer in patients submitted to neoadjuvant therapy in a private clinic of Cascavel/PR




Breast cancer; Pathological response; Neoadjuvant chemotherapy.


The present study aimed to analyze the clinical-pathological profile of patients diagnosed with breast cancer and treated with neoadjuvant chemotherapy at COOP from July 2014 to July 2019. Neoadjuvant therapies have the purpose of reduce the tumor burden and improving the pathological complete response (pCR) in patients with advanced tumors and conserving the breast in initial tumors. The pathological response is a way to evaluate the effectiveness of this modality of treatment, as well as the benefits brought by it. The study in question made a quantitative, qualitative and descriptive analysis, in a retrograde way, using physical records from COOP. The conclusion is that there is a statistical association of patients who achieved pCR with younger age, higher levels of Ki-67, absense of estrogen and progesterone hormonal receptor and presence of HER-2 receptor. Therefore, this treatment modality should be considered in patients with a similar profile to obtain a better clinical outcome.


Andrade, D. A. P. de, Zucca-Matthes, G., Vieira, R. A. da C., Andrade, C. T. de A. E. de, Costa, A. M. da, Monteiro, A. J. de C., Dal Lago, L., & Nunes, J. S. (2013). Quimioterapia neoadjuvante e resposta patológica: coorte retrospectiva. Einstein (São Paulo), 11(4), 446–450.

Asselain, B., Barlow, W., Bartlett, J., Bergh, J., Bergsten-Nordström, E., Bliss, J., Boccardo, F., Boddington, C., Bogaerts, J., Bonadonna, G., Bradley, R., Brain, E., Braybrooke, J., Broet, P., Bryant, J., Burrett, J., Cameron, D., Clarke, M., Coates, A., & Zujewski, J. A. (2018). Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. The Lancet Oncology, 19(1), 27–39.

Campbell, J. I., Yau, C., Krass, P., Moore, D., Carey, L. A., Au, A., Chhieng, D., Giri, D., Livasy, C., Mies, C., Rabban, J., Sarode, V. R., Singh, B., Esserman, L., & Chen, Y. Y. (2017). Comparison of residual cancer burden, American Joint Committee on Cancer staging and pathologic complete response in breast cancer after neoadjuvant chemotherapy: results from the I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657). Breast Cancer Research and Treatment, 165(1), 181–191.

Chou, H. H., Kuo, W. L., Yu, C. C., Tsai, H. P., Shen, S. C., Chu, C. H., Yu, M. C., Lo, Y. F., Dabora, M. A., Chang, H. K., Lin, Y. C., Ueng, S. H., & Chen, S. C. (2019). Impact of age on pathological complete response and locoregional recurrence in locally advanced breast cancer after neoadjuvant chemotherapy. Biomedical Journal, 42(1), 66–74.

Colleoni, M., Minchella, I., Mazzarol, G., Nole, F., Peruzzotti, G., Rocca, A., Viale, G., Orlando, L., Ferretti, G., Curigliano, G., Veronesi, P., Intra, M., & Goldhirsch, A. (2000). Original article Response to primary chemotherapy in breast cancer patients with tumors. Annals of Oncology, 11, 1057–1059.

Cortazar, P., & Geyer, C. E. (2015). Pathological Complete Response in Neoadjuvant Treatment of Breast Cancer. Annals of Surgical Oncology, 22(5), 1441–1446.

Cortazar, P., Zhang, L., Untch, M., Mehta, K., Costantino, J. P., Wolmark, N., Bonnefoi, H., Cameron, D., Gianni, L., Valagussa, P., Swain, S. M., Prowell, T., Loibl, S., Wickerham, D. L., Bogaerts, J., Baselga, J., Perou, C., Blumenthal, G., Blohmer, J., … Von Minckwitz, G. (2014). Pathological complete response and long-term clinical benefit in breast cancer: The CTNeoBC pooled analysis. The Lancet, 384(9938), 164–172.

Esserman, L. J., Berry, D. A., DeMichele, A., Carey, L., Davis, S. E., Buxton, M., Hudis, C., Gray, J. W., Perou, C., Yau, C., Livasy, C., Krontiras, H., Montgomery, L., Tripathy, D., Lehman, C., Liu, M. C., Olopade, O. I., Rugo, H. S., Carpenter, J. T., & Hylton, N. (2012). Pathologic complete response predicts recurrence-free survival more effectively by cancer subset: Results from the I-SPY 1 TRIAL - CALGB 150007/150012, ACRIN 6657. Journal of Clinical Oncology, 30(26), 3242–3249.

Fayanju, O. M., Ren, Y., Thomas, S. M., Greenup, R. A., Plichta, J. K., Rosenberger, L. H., Tamirisa, N., Force, J., Boughey, J. C., Hyslop, T., & Hwang, E. S. (2018). The clinical significance of breast-only and node-only pathologic complete response (PCR) after neoadjuvant chemotherapy (NACT): A review of 20,000 breast cancer patients in the National Cancer Data Base (NCDB). Annals of Surgery, 268(4), 591–601.

Gianni, L., Baselga, J., Eiermann, W., Porta, V. G., Semiglazov, V., Lluch, A., Zambetti, M., Sabadell, D., Raab, G., Cussac, A. L., Bozhok, A., Martinez-Agulló, A., Greco, M., Byakhov, M., Lopez Lopez, J. J., Mansutti, M., Valagussa, P., & Bonadonna, G. (2005). Feasibility and tolerability of sequential doxorubicin/paclitaxel followed by cyclophosphamide, methotrexate, and fluorouracil and its effects on tumor response as preoperative therapy. Clinical Cancer Research, 11(24), 8715–8721.

Gianni, L., Eiermann, W., Semiglazov, V., Manikhas, A., Lluch, A., Tjulandin, S., Zambetti, M., Vazquez, F., Byakhow, M., Lichinitser, M., Climent, M. A., Ciruelos, E., Ojeda, B., Mansutti, M., Bozhok, A., Baronio, R., Feyereislova, A., Barton, C., Valagussa, P., & Baselga, J. (2010). Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. The Lancet, 375(9712), 377–384.

Gralow, J. R., Burstein, H. J., Wood, W., Hortobagyi, G. N., Gianni, L., Von Minckwitz, G., Buzdar, A. U., Smith, I. E., Symmans, W. F., Singh, B., & Winer, E. P. (2008). Preoperative therapy in invasive breast cancer: Pathologic assessment and systemic therapy issues in operable disease. Journal of Clinical Oncology, 26(5), 814–819.

Guarneri, V., Broglio, K., Kau, S. W., Cristofanilli, M., Buzdar, A. U., Valero, V., Buchholz, T., Meric, F., Middleton, L., Hortobagyi, G. N., & Gonzalez-Angulo, A. M. (2006). Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors. Journal of Clinical Oncology, 24(7), 1037–1044.

Huang, E. H., Tucker, S. L., Strom, E. A., McNeese, M. D., Kuerer, H. M., Buzdar, A. U., Valero, V., Perkins, G. H., Schechter, N. R., Hunt, K. K., Sahin, A. A., Hortobagyi, G. N., & Buchholz, T. A. (2004). Postmastectomy radiation improves local-regional control and survival for selected patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and mastectomy. Journal of Clinical Oncology, 22(23), 4639–4647.

Jones, R. L., Lakhani, S. R., Ring, A. E., Ashley, S., Walsh, G., & Smith, I. E. (2006). Pathological complete response and residual DCIS following neoadjuvant chemotherapy for breast carcinoma. British Journal of Cancer, 94(3), 358–362.

Llombart-Cussac, A., Cortés, J., Paré, L., Galván, P., Bermejo, B., Martínez, N., Vidal, M., Pernas, S., López, R., Muñoz, M., Nuciforo, P., Morales, S., Oliveira, M., de la Peña, L., Peláez, A., & Prat, A. (2017). HER2-enriched subtype as a predictor of pathological complete response following trastuzumab and lapatinib without chemotherapy in early-stage HER2-positive breast cancer (PAMELA): an open-label, single-group, multicentre, phase 2 trial. The Lancet Oncology, 18(4), 545–554.

Mamtani, A., Barrio, A. V., King, T. A., Van Zee, K. J., Plitas, G., Pilewskie, M., El-Tamer, M., Gemignani, M. L., Heerdt, A. S., Sclafani, L. M., Sacchini, V., Cody, H. S., Patil, S., & Morrow, M. (2016). How Often Does Neoadjuvant Chemotherapy Avoid Axillary Dissection in Patients With Histologically Confirmed Nodal Metastases? Results of a Prospective Study. Annals of Surgical Oncology, 23(11), 3467–3474.

McGuire, S. E., Gonzalez-Angulo, A. M., Huang, E. H., Tucker, S. L., Kau, S. W. C., Yu, T. K., Strom, E. A., Oh, J. L., Woodward, W. A., Tereffe, W., Hunt, K. K., Kuerer, H. M., Sahin, A. A., Hortobagyi, G. N., & Buchholz, T. A. (2007). Postmastectomy Radiation Improves the Outcome of Patients With Locally Advanced Breast Cancer Who Achieve a Pathologic Complete Response to Neoadjuvant Chemotherapy. International Journal of Radiation Oncology Biology Physics, 68(4), 1004–1009.

Osório, C. A. B. T., Júnior, M. A. C., & Soares, F. A. (2012). Avaliação de resposta patológica em câncer de mama após quimioterapia neoadjuvante: Padronização de protocolo adaptado. Jornal Brasileiro de Patologia e Medicina Laboratorial, 48(6), 447–453.

Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM

Rastogi, P., Anderson, S. J., Bear, H. D., Geyer, C. E., Kahlenberg, M. S., Robidoux, A., Margolese, R. G., Hoehn, J. L., Vogel, V. G., Dakhil, S. R., Tamkus, D., King, K. M., Pajon, E. R., Wright, M. J., Robert, J., Paik, S., Mamounas, E. P., & Wolmark, N. (2008). Preoperative chemotherapy: Updates of national surgical adjuvant breast and bowel project protocols B-18 and B-27. Journal of Clinical Oncology, 26(5), 778–785.

Ring, A. E., Smith, I. E., Ashley, S., Fulford, L. G., & Lakhani, S. R. (2004). Oestrogen receptor status, pathological complete response and prognosis in patients receiving neoadjuvant chemotherapy for early breast cancer. British Journal of Cancer, 91(12), 2012–2017.

Tan, M. C., Al Mushawah, F., Gao, F., Aft, R. L., Gillanders, W. E., Eberlein, T. J., & Margenthaler, J. A. (2009). Predictors of complete pathological response after neoadjuvant systemic therapy for breast cancer. American Journal of Surgery, 198(4), 520–525.

Tan, Q. X., Qin, Q. H., Yang, W. P., Mo, Q. G., & Wei, C. Y. (2014). Prognostic value of Ki67 expression in HR-negative breast cancer before and after neoadjuvant chemotherapy. International Journal of Clinical and Experimental Pathology, 7(10), 6862–6870.

Von Minckwitz, G., Untch, M., Blohmer, J. U., Costa, S. D., Eidtmann, H., Fasching, P. A., Gerber, B., Eiermann, W., Hilfrich, J., Huober, J., Jackisch, C., Kaufmann, M., Konecny, G. E., Denkert, C., Nekljudova, V., Mehta, K., & Loibl, S. (2012). Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. Journal of Clinical Oncology, 30(15), 1796–1804.

Von Minckwitz, G., Raab, G., Caputo, A., Schütte, M., Hilfrich, J., Blohmer, J. U., Gerber, B., Costa, S. D., Merkle, E., Eidtmann, H., Lampe, D., Jackisch, C., Du Bois, A., & Kaufmann, M. (2005a). Doxorubicin with cyclophosphamide followed by docetaxel every 21 days compared with doxorubicin and docetaxel every 14 days as preoperative treatment in operable breast cancer: The GEPARDUO study of the German Breast Group. Journal of Clinical Oncology, 23(12), 2676–2685.

Von Minckwitz, G., Blohmer, J. U., Raab, G., Löhr, A., Gerber, B., Heinrich, G., Eidtmann, H., Kaufmann, M., Hilfrich, J., Jackisch, C., Zuna, I., & Costa, S. D. (2005b). In vivo chemosensitivity-adapted preoperative chemotherapy in patients with early-stage breast cancer: The GEPARTRIO pilot study. Annals of Oncology, 16(1), 56–63.

Wang, C., Chen, J., Xu, X., Hu, X., Kong, D., Liang, G., & Wang, X. (2020). Dual HER2 Blockade in Neoadjuvant Treatment of HER2+ Breast Cancer: A Meta-Analysis and Review. Technology in Cancer Research & Treatment, 19, 1–10.

Wolmark, N., Wang, J., Mamounas, E., Bryant, J., & Fisher, B. (2001). Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. Journal of the National Cancer Institute. Monographs, 15212(30), 96–102.



How to Cite

RANZAN, I. C. .; AGUIAR NETO, A. P. de .; FURLAN NETO, R.; TESSARO, R. A. R. .; FALCONI, P. P. .; BONILHA, G. S. .; VICINI , K. M. .; RAUEN, G. O. .; GOMES, D. S. . Pathological response analysis of breast cancer in patients submitted to neoadjuvant therapy in a private clinic of Cascavel/PR. Research, Society and Development, [S. l.], v. 10, n. 6, p. e18610615461, 2021. DOI: 10.33448/rsd-v10i6.15461. Disponível em: Acesso em: 23 jun. 2021.



Health Sciences