Evaluation of long-term results of treatment of patients with residual tumors (including those with minimal forms of ypT1abN0), with pathomorphological complete response (pCR) after neoadjuvant systemic therapy, with primary minimal breast cancer (pT1abN0M0)

DOI: https://dx.doi.org/10.18565/pharmateca.2023.6-7.59-67

R.S. Pesotsky, V.F. Semiglazov, P.V. Krivorotko, T.T. Tabagua, K.Yu. Zernov, A.S. Emelyanov, T.Yu. Semiglazova, N. Amirov, V.V. Mortada, D.G. Ulrikh, V.E. Levchenko, K.Yu. Rychagov, K.Yu. Zirov, V.N. Evseev

1) N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia; 2) Russian Biotechnological University (ROSBIOTECH), Moscow, Russia; 3) LLC MEDSI, St. Petersburg, Russia; 4) City Clinical Oncological Dispensary, St. Petersburg, Russia; 5) North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia
Background. Initially, minimal tumors are characterized by high survival rates, which are proved by international and domestic studies. It is required to clarify the survival rates in the presence of a minimal residual tumor (ypT <10mm) after neoadjuvant systemic therapy in patients with breast cancer (BC) and to compare with primary minimal forms of BC (pT1a-b N0M0), characterized by the most favorable prognosis.
Objective. Improvement of the effectiveness of treatment of residual minimal forms (ypT1a-b) of BC after NST.
Methods. The study included 602 patients aged 18–65 years with early and locally advanced I–IIIC stage T1-3N1-3M0 breast cancer, who underwent complex or combined treatment. This study included patients treated at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2021.
Results and discussion. Our data analysis revealed that the survival rates (DFS and OS) of patients with minimal residual tumor after neojuvant systemic therapy were not comparable with those in the group of patients with primary minimal breast cancer.
Conclusion. After reaching a complete pathomorphological response of the tumor to NST (RCB 0), the 5-year disease-free (DFS) and overall (OS) survival rates (DFS – 78.5%; OS – 90.4%) were inferior to the survival rates of patients with primary minimal breast cancer (pT1ab N0M0) [DFS – 86.4%; OS – 98.6%].

About the Autors

Corresponding author: Roman S. Pesotsky, Oncologist, Department of Breast Tumors, N.N. Petrov National Medical Research Center of Oncology, St. Petersburg, Russia; shipmeback@gmail.com

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