PDF(Pubmed)
Abstract：
UNASSIGNED: HER2-positive breast carcinomas (BCs) generally behave more aggressively and show higher cytological and histological grade than HER2-negative BCs. However, the clinical properties of HER2-positive early BCs have not been studied extensively. Hence, the therapeutic significance of neoadjuvant chemotherapy (NAC) for this BC remains debatable.
UNASSIGNED: We retrospectively examined the clinicopathological features of 94 HER2-positive early BCs who perioperatively received anti-HER2 drugs, without undergoing NAC prior to surgery.
UNASSIGNED: The patients\' five year-disease free survival (DFS) and overall survival (OS) rates were 95.6% and 100%, respectively. Univariate analysis demonstrated significant differences in distant metastasis-free survival (DMFS) between clinical and pathological tumor stages (T stages). Pathological T1 stage and clinical T1 stage tumors showed significantly higher DMSF than pT2-3 and cT2-3 (p=0.0002 and 0.0294). Multivariate analysis disclosed no significant differences in DFS, OS, and DMFS with respect to preoperative clinical tumor stage, patient age, type of surgery, postoperative therapy, and pathological factors. Recurrences occurred in nine patients: four (4.3%) and five (5.3%) patients showed local and distant recurrences, respectively. One patient with cT2 BC died of disease. Interestingly, four of the five BCs with distant recurrence pathologically demonstrated lymph vessel invasion. The prognoses of patients with HER2-positive stage cT1/2N0M0 BC were highly favorable.
UNASSIGNED: The indications for NAC in small, localized, and node-negative HER2-positive BC should be carefully assessed based on the presence of a larger tumor size, postoperative pathological evaluation of tumor size, and lymph vessel invasion.
UNASSIGNED: We retrospectively examined the clinicopathological features of 94 HER2-positive early BCs who perioperatively received anti-HER2 drugs, without undergoing NAC prior to surgery.
UNASSIGNED: The patients\' five year-disease free survival (DFS) and overall survival (OS) rates were 95.6% and 100%, respectively. Univariate analysis demonstrated significant differences in distant metastasis-free survival (DMFS) between clinical and pathological tumor stages (T stages). Pathological T1 stage and clinical T1 stage tumors showed significantly higher DMSF than pT2-3 and cT2-3 (p=0.0002 and 0.0294). Multivariate analysis disclosed no significant differences in DFS, OS, and DMFS with respect to preoperative clinical tumor stage, patient age, type of surgery, postoperative therapy, and pathological factors. Recurrences occurred in nine patients: four (4.3%) and five (5.3%) patients showed local and distant recurrences, respectively. One patient with cT2 BC died of disease. Interestingly, four of the five BCs with distant recurrence pathologically demonstrated lymph vessel invasion. The prognoses of patients with HER2-positive stage cT1/2N0M0 BC were highly favorable.
UNASSIGNED: The indications for NAC in small, localized, and node-negative HER2-positive BC should be carefully assessed based on the presence of a larger tumor size, postoperative pathological evaluation of tumor size, and lymph vessel invasion.
摘要：
■HER2阳性乳腺癌(BCs)通常表现得比HER2阴性BCs更具侵袭性,并且表现出更高的细胞学和组织学分级。然而,HER2阳性早期BCs的临床特性尚未得到广泛研究.因此，新辅助化疗(NAC)对该BC的治疗意义仍有争议.
■我们回顾性研究了94例HER2阳性早期BCs的临床病理特征，这些BCs围手术期接受了抗HER2药物，手术前没有接受NAC。
■患者的五年无病生存率（DFS）和总生存率（OS）分别为95.6％和100％，分别。单变量分析表明，临床和病理肿瘤分期（T分期）之间的无远处转移生存期（DMFS）存在显着差异。病理T1期和临床T1期肿瘤显示DMSF显著高于pT2-3和cT2-3(p=0.0002和0.0294)。多变量分析显示DFS没有显着差异，操作系统,和DMFS相对于术前临床肿瘤分期，患者年龄,手术类型,术后治疗,和病理因素。9例患者出现复发：4例（4.3％）和5例（5.3％）患者出现局部和远处复发，分别。一名cT2BC患者死于疾病。有趣的是,5例远处复发的BCs中有4例经病理证实有淋巴管浸润。HER2阳性cT1/2N0M0BC期患者的预后非常好。
■NAC的适应症较小，局部化,和淋巴结阴性HER2阳性BC应根据是否存在较大的肿瘤大小仔细评估，术后病理评估肿瘤大小，和淋巴管侵入。
■我们回顾性研究了94例HER2阳性早期BCs的临床病理特征，这些BCs围手术期接受了抗HER2药物，手术前没有接受NAC。
■患者的五年无病生存率（DFS）和总生存率（OS）分别为95.6％和100％，分别。单变量分析表明，临床和病理肿瘤分期（T分期）之间的无远处转移生存期（DMFS）存在显着差异。病理T1期和临床T1期肿瘤显示DMSF显著高于pT2-3和cT2-3(p=0.0002和0.0294)。多变量分析显示DFS没有显着差异，操作系统,和DMFS相对于术前临床肿瘤分期，患者年龄,手术类型,术后治疗,和病理因素。9例患者出现复发：4例（4.3％）和5例（5.3％）患者出现局部和远处复发，分别。一名cT2BC患者死于疾病。有趣的是,5例远处复发的BCs中有4例经病理证实有淋巴管浸润。HER2阳性cT1/2N0M0BC期患者的预后非常好。
■NAC的适应症较小，局部化,和淋巴结阴性HER2阳性BC应根据是否存在较大的肿瘤大小仔细评估，术后病理评估肿瘤大小，和淋巴管侵入。
