Is complete pathological response truly a complete response in breast cancer?

Authors

  • Bushra Rehman Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Sara Rehman Department of Breast Imaging, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Sameen Mohtasham Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Toqeer Zahid Department of Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Albash Sarwar Department of Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • Muhammad Asad Parvaiz Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

DOI:

https://doi.org/10.47391/JPMA.5574

Abstract

Objective: To check if complete pathological response in breast cancer is a good prognostic factor.

Method: The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data from January 2012 to December 2015 of all patients who received neo-adjuvant chemotherapy and had no distant metastasis at diagnosis. Mastectomy patients were excluded. Complete pathological response was defined as no detectable tumour cell in breast and axilla on pathological examination of the resected specimen. Tumour characteristics and 5-year disease free survival and overall survival were recorded. Data was analysed using SPSS 20.

Results: Of the 353 patients whose data was evaluated, 91(25.8%) had complete pathological response. Mean age at diagnosis was 43+/-10 years. Among them, 62(68%) patients had grade III tumour, 39(42.9%) were negative for oestrogen receptor, 58(63.7%) were negative for progesterone receptor, 25(27.5%) were positive for human epidermal growth factor receptor 2, and 26(28.6%) patients were triple negative. Overall, 28((30.7%) patients had recurrence; 20(71.4%) had distant metastasis, 6(21.4%) had local recurrence, and 2(7.14%) had contralateral cancer. The 5-year disease-free survival and overall survival rates (Kaplan-Meier Survial curve) were 70% (28 patients-recurrence) and 87% (15 patients-deaths), respectively.

Conclusion: Despite complete disappearance of tumour, a significant number of patients developed recurrences.

Key Words: Complete pathological response, Neo-adjuvant chemotherapy, Survival, Metastasis.

Author Biographies

Sara Rehman, Department of Breast Imaging, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Senior Instructor Woman Imaging

Sameen Mohtasham, Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Resident Department of surgey 

Toqeer Zahid, Department of Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Resident surgery department 

Albash Sarwar, Department of Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Residend Surgery Department 

Muhammad Asad Parvaiz, Department of Breast Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Consultant Breast Surgeon

Published

2023-02-15

How to Cite

Rehman, B., Sara Rehman, Sameen Mohtasham, Toqeer Zahid, Albash Sarwar, & Muhammad Asad Parvaiz. (2023). Is complete pathological response truly a complete response in breast cancer?. Journal of the Pakistan Medical Association, 73(2), 280–289. https://doi.org/10.47391/JPMA.5574

Issue

Section

Research Article

Most read articles by the same author(s)