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      Conventional Tools for Predicting Satisfactory Response to Neoadjuvant Chemotherapy in HR+/HER2− Breast Cancer Patients

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          Abstract

          Aim: The aim of the study was to assess the role of Magee Equation 3 (MagEq3), IHC4 score, and HER2-low status in predicting “satisfactory response (SR)” to neoadjuvant chemotherapy (NAC) in HR+/HER2− breast cancer (BC) patients. Methods: In a retrospective study, female patients of any age with T<sub>1–4</sub>, N<sub>0–2</sub>, M<sub>0</sub> HR+/HER2− BC who received NAC and underwent adequate locoregional surgical treatment were included. Patients were grouped according to 2 outcomes: (a) overall response to NAC in breast and axilla by using residual cancer burden (RCB) criteria and (b) axillary downstaging after NAC by using N staging. 2 cohorts for overall response were overall SR (RCB 0–1) and no SR (RCB 2–3). On the other hand, for axillary downstaging, 2 cohorts constituted from axillary SR (ypN<sub>0</sub> and ypN<sub>0i+</sub>) and no SR (ypN<sub>mic-N3</sub>). MagEq3 and IHC4 scores were calculated from their pathological tumor slides in each patient. HER2 status was categorized as either “no” or “low.” In addition, patient age, family history, tumor histology, stage at admission, and Ki-67 status were compared between cohorts according to predefined outcomes. Results: In a total of 230 BC patients, 228 patients were included to compare according to their RCB levels. The mean age of patients with overall SR was significantly lower than those without. Patients with high Ki-67 expression, high (>30) MagEq3 score, high ICH4 quartile, and HER2-low status had significantly more overall SR. On the other hand, only patients with high Ki-67 expression had significantly more axillary SR. MagEq3 score levels, ICH4 quartiles, and HER2 status were similar between patients with axillary SR and not. Conclusion: MagEq3 and IHC4 tools seemed to be useful to predict those HR+/HER2− BC patients who are most likely to get benefit from NAC. But, only high Ki-67 expression level significantly predicted satisfactory axillary downstaging in HR+/HER2− BC patients.

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          Author and article information

          Journal
          BRC
          BRC
          10.1159/issn.1661-3791
          Breast Care
          Breast Care
          S. Karger AG
          1661-3791
          1661-3805
          2023
          October 2023
          20 May 2023
          : 18
          : 5
          : 344-353
          Affiliations
          [_a] aDepartment of Obstetrics and Gynecology 2, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
          [_b] bDepartment of Surgery, Marmara University School of Medicine, Istanbul, Turkey
          [_c] cDepartment of Surgery, Trakya University School of Medicine, Edirne, Turkey
          [_d] dDepartment of Pathology, Marmara University School of Medicine, Istanbul, Turkey
          [_e] eDepartment of Medical Oncology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
          [_f] fDepartment of Pathology, Trakya University School of Medicine, Edirne, Turkey
          [_g] gDepartment of Surgical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
          [_h] hDepartment of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
          [_i] iSurgical Clinic Mureș County Clinical Hospital, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
          Author information
          https://orcid.org/0000-0001-9889-2702
          https://orcid.org/0000-0001-6156-7260
          https://orcid.org/0000-0001-7085-4755
          Article
          531117 Breast Care 2023;18:344–353
          10.1159/000531117
          37901046
          00b65ae6-acfa-4e8f-8785-329389ba03f9
          © 2023 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 14 December 2022
          : 15 May 2023
          Page count
          Tables: 5, Pages: 10
          Funding
          The study received funding from George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mure?, Romania.
          Categories
          Research Article

          Medicine
          IHC4 score,Low HER2,Breast cancer,Neoadjuvant treatment,Luminal cancer,Magee Equation
          Medicine
          IHC4 score, Low HER2, Breast cancer, Neoadjuvant treatment, Luminal cancer, Magee Equation

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