Original articleValidation of the CPS+EG and Neo-Bioscore staging systems after preoperative systemic therapy for breast cancer in a single center in China
Section snippets
Background
Preoperative systemic therapy (PST) or neoadjuvant chemotherapy (NAC) has become part of the standard treatment regimen for breast cancer patients with locally advanced disease and is increasingly being used in clinical practice. In addition to reducing tumor burden and thus permitting conservative breast surgery and fewer surgeries, PST provides a good opportunity to evaluate the response of breast cancer to systemic treatments. Numerous studies have demonstrated that the degree of reduction
Patient population
Data from 479 consecutive patients diagnosed with primary nonmetastatic breast cancer who underwent PST from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China were retrospectively reviewed. All patients were diagnosed by core needle biopsy (CNB) of primary breast foci, and lymph nodes were evaluated by fine needle biopsy (FNB) if clinically positive or by sentinel lymph node biopsy (SLNB) if clinically or FNB-negative. From this cohort, 76 cases were
Patient characteristics
A total of 403 patients with complete data based on multiple staging systems were enrolled in this study. The characteristics of all 403 patients are listed in Table 2. The median age was 50 (range 22–74) years. The median follow-up period was 45 (range 11–107) months. Two patients (0.5%) were male. A total of 121 patients (30%) were HER2-positive, and 74 (61.2%) received trastuzumab combined with PST. A pCR was achieved in 22.3% (n = 90) of patients in the overall cohort.
The distribution of
Discussion
In our study, the CPS + EG and Neo-Bioscore scoring systems were validated for their ability to stratify breast cancer patients after PST according to prognosis. More importantly, the prognostic predictions were investigated not only for DSS but also for DFS and OS. The CPS + EG score and Neo-Bioscore staging systems were obviously better than CS. Although the HER2 status has been considered in the Neo-Bioscore staging system, generally speaking, no superiority was seen when this score was
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
The research leading to these results has received funding from the grant: National Key R&D Program of China (grant number: 2016YFC0901302).
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