Impact of Neo-Adjuvant Chemotherapy in Triple Negative Breast Cancers

Authors

  • Sooma Hafeez Shaikh Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
  • Muhammad Umair Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
  • Ummarah Zafar Farid Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
  • Amaar Talib Department of Orthopedic Surgery, Punjab Rangers Teaching Hospital, Lahore Pakistan
  • Yusra Ashraf Department of Pediatric Surgery, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
  • Laiba Binte Saleem Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-2.13111

Keywords:

Chemotherapy, Neoadjuvant, Nodal Involvement, Pathological Complete Response, Triple-Negative Breast Cancer

Abstract

Objective: To evaluate the impact of Neo-Adjuvant Chemotherapy on Pathological Complete Response rates, in patients with Triple-Negative Breast Cancer, focusing on the relationship between tumor size, nodal involvement, type of surgery, and treatment outcomes.

Study Design: Prospective cohort study.

Place and Duration of Study: Pakistan Navy Station Shifa Hospital, Karachi Pakistan, from Feb 2023 to Feb 2025.

Methodology: A total of 88 patients with triple-negative breast cancer who received neoadjuvant chemotherapy were included. Baseline characteristics, including tumor size, nodal involvement, and type of surgery, were recorded. The chi-square test was used to compare pathological complete response rates between subgroups. A p-value of <0.05 was considered statistically significant.

Results: The overall Pathological Complete Response rate was 43.18%. Nodal involvement was significantly associated with Pathological Complete Response (p=0.01), with N0 patients achieving higher response rates compared to N1 and N2 patients. Tumor size and type of surgery were not significantly associated with Pathological Complete Response (p=0.13 and p=0.30, respectively). Tumor size and type of surgery did not significantly affect outcomes. Adverse effects were observed in 21.59% of patients, with no significant impact.

Conclusion: Neo-Adjuvant Chemotherapy is effective in achieving Pathological Complete Response in Triple-Negative Breast Cancer patients, particularly in those without nodal involvement.

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References

Lehmann BD, Jovanović B, Chen X, Estrada MV, Johnson KN, Shyr Y, et al. Refinement of triple-negative breast cancer molecular subtypes: Implications for neoadjuvant chemotherapy selection. PLoS One 2016; 11(6).

Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, et al. Pathological complete response and long-term clinical benefit in breast cancer: The CTNeoBC pooled analysis. Lancet 2014; 384(9938): 164–172.

Bianchini G, Balko JM, Mayer IA, Sanders ME, Gianni L. Triple-negative breast cancer: Challenges and opportunities of a heterogeneous disease. Nat Rev Clin Oncol 2016; 13(11): 674–690.

Li X, Yang J, Peng L, Sahin AA, Huo L, Ward KC, et al. Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer. Breast Cancer Res Treat 2017; 161(2): 279-287.

Azamjah N, Soltan-Zadeh Y, Zayeri F. Global Trend of Breast Cancer Mortality Rate: A 25-Year Study. Asian Pac J Cancer Prev 2019; 20(7): 2015-2020.

Tahir S, Avesi L, Danish F, Hassan Shamim S, Bukhari U, Muhammad Ali F. Immunohistochemical Expression of Ki-67 and p53 in Different Grades of Phyllodes Tumors of the Breast and its Association with Clinicopathological Characteristics. J Postgrad Med Inst [Internet] 2024: 30; 38(3).

Li X, Yang J, Peng L, Sahin AA, Huo L, Ward KC, et al. Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer. Breast Cancer Res Treat 2017; 161(2): 279-287.

Sharma P, Kimler BF, O'Dea A, Nye L, Wang YY, Yoder R, et al. Randomized Phase II Trial of Anthracycline-free and Anthracycline-containing Neoadjuvant Carboplatin Chemotherapy Regimens in Stage I-III Triple-negative Breast Cancer (NeoSTOP). Clin Cancer Res 2021; 27(4): 975-982.

Chiragh S, Bilal A, Rahimullah, Sohail A, Abdullah K. Evaluation of pathological complete response following neo adjuvant chemotherapy in breast cancer patients. J Postgrad Med Inst 2023; 37(4): 256-261.

Hanif MR, Wahab A, Moeed A, Khan SA, Sheikh RM, Siddiqui N. Response of Neoadjuvant Chemotherapy in Triple Negative Breast Cancer and the Impact of Pathologic Complete Response on Survival, an Institutional Research. Pak Armed Forces Med J 2024; 74(3): 675-679.

Spring LM, Fell G, Arfe A, Sharma C, Greenup R, Moy B, et al. Pathological complete response after neoadjuvant chemotherapy and impact on breast cancer recurrence and survival: A comprehensive meta-analysis. Clin Cancer Res 2020; 26(12): 2838–2848.

Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 2010; 28(10): 1684–1691.

Chu QD, Henderson AE, Ampil F, Li BD. Outcome for patients with triple-negative breast cancer is not dependent on race/ethnicity. Int J Breast Cancer 2012; 764570.

Herrero-Vicent C, Guerrero A, Gavilá J, Gozalbo F, Hernández A, Sandiego S, et al. Predictive and prognostic impact of tumour-infiltrating lymphocytes in triple-negative breast cancer treated with neoadjuvant chemotherapy. Ecancermedicalscience 2017; 11: 759.

Zhang J, Wang W, Wang J, Luo Y, Chen S, Ma F, et al. Survival Outcome and Impact of Chemotherapy in T1 Node-Negative Triple-Negative Breast Cancer: A SEER Database Analysis. J Oncol 2020; 8880727.

Poggio F, Bruzzone M, Ceppi M, Pondé NF, La Valle G, Del Mastro L, et al. Platinum-based neoadjuvant chemotherapy in triple-negative breast cancer: a systematic review and meta-analysis. Annals of Oncology 2018; 29(7): 1497-1508.

Anderson SJ, Wapnir I, Dignam JJ, Fisher B, Mamounas EP, Jeong JH, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol 2009; 27(15): 2466-2473.

Von Minckwitz G, Martin M. Neoadjuvant treatments for triple-negative breast cancer (TNBC). Annals of oncology 2012; 23: 35-39

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Published

25-03-2025

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How to Cite

1.
Shaikh SH, Umair M, Farid UZ, Talib A, Ashraf Y, Saleem LB. Impact of Neo-Adjuvant Chemotherapy in Triple Negative Breast Cancers. Pak Armed Forces Med J [Internet]. 2025 Mar. 25 [cited 2025 Apr. 6];75(SUPPL-2):S340-S344. Available from: https://pafmj.org/PAFMJ/article/view/13111