Axillary pCR linked to improved breast cancer survival

(HealthDay)—For women with breast cancer treated with primary systemic chemotherapy (PST), achieving axillary pathologic complete response (pCR) is associated with improved survival, according to a study published online Dec. 30 in JAMA Oncology.

Sarah S. Mougalian, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues examined the long-term effect of axillary pCR on relapse-free survival (RFS) and overall survival (OS) among women who received a diagnosis of breast cancer stages II to III. Participants had cytologically confirmed axillary metastases and were treated with PST. Data were included for 1,600 women, of whom 28.4 percent achieved axillary pCR.

The researchers found that patients who achieved axillary pCR were more likely to have human epidermal growth factor receptor 2 (HER2)-positive and triple-negative disease, pCR in the breast, and high-grade tumors (all P < 0.001), and to have lower clinical and pathological T stage (P = 0.002). For patients with axillary pCR and residual axillary disease, the 10-year OS rates were 84 and 57 percent, respectively, while the corresponding 10-year RFS rates were 79 and 50 percent. Axillary pCR was achieved by 67.1 percent of patients receiving HER2-targeted therapy for HER2-positive disease; the 10-year OS rates were 92 and 57 percent for those with axillary pCR and residual axillary disease, respectively; the corresponding 10-year RFS rates were 89 and 44 percent.

"Axillary pCR was associated with improved 10-year OS and RFS," the authors write.

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