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Abstract
Introduction/Background The indications for neoadjuvant chemotherapy have evolved
Neoadjuvant chemotherapy has become an essential part of the treatment strategy, particularly for triple-negative and HER2+ subtypes.
Methodology A retrospective study of 136 patients with triple-negative breast cancer or HER 2+ status who received neoadjuvant chemotherapy and were treated surgically at the Mohammed VI Center for Gynaeco-Oncology, over an 18-month period from January 2022 to June 2023
Results Among our 136 patients, triple-negative breast cancer cases represented 29%. On the other hand, RH+/HER2 positive breast cancer represented 48%. and 25% of patients had RH-/HER2+ breast cancer.
The breast nodule was the predominant symptom in 96% of cases, and the mean clinical size in our series was 5.25 cm, with extremes of 1 cm and 15 cm.
The mean ultrasound size in our series was 3.83 cm, with extremes of 1.2 cm and 12.5 cm.
Histological data showed a predominance of non-specific invasive breast carcinoma in 95% of cases, SBR grades II and III were marked in 96% of our patients, and Ki-67 was elevated in 89% of cases
For neoadjuvant chemotherapy, the average number of courses was 6. The sequential protocol was the most commonly used, combining an anthracycline with a taxane.
The clinical therapeutic response to neoadjuvant chemotherapy was complete in 43% of our patients.
The mean time between neoadjuvant chemotherapy and surgery was 8 weeks, with intervals of 2 to 36 weeks. 66% of patients underwent radical surgery, compared with 34% who underwent conservative surgery.
The histological response, 32% had a complete response.
Conclusion Neoadjuvant chemotherapy plays an essential role in the management of breast cancer, particularly triple-negative and HER2+ subtypes.
It optimises tumour resectability
Complete histological response is the major indicator of survival, underlining the efficacy of the treatment
Disclosures Penault-Llorca F, Abrial C, Raoelfils I, Cayre A, Mouret-Reynier MA, Leheurteur M, Durando X, Achard JL, Gimbergues P, Chollet P. Comparison of the prognostic significance of Chevallier and Sataloff’s pathologic classifications after neoadjuvant chemotherapy of operable breast cancer. Hum Pathol. 2008 Aug;39(8):1221–8. doi: 10.1016/j.humpath.2007.11.019. Epub 2008 Jun 10. PMID: 18547616.
Le Guellec S, Perallon R, Alunni JP, Charitansky H, Leaha C, Gonzalez AM, Chateau MC, Simony-Lafontaine J, Jacot W, Gutowski M, Penault-Llorca F, Dalenc F, Lacroix-Triki M. Place du pathologiste dans la prise en charge néoadjuvante des cancers du sein [Neoadjuvant treatment of breast cancer: implications for the pathologist]. Ann Pathol. 2011 Dec;31(6):442–54. French. doi: 10.1016/j.annpat.2011.10.003. Epub 2011 Nov 23. PMID: 22172117.
