{Reference Type}: Journal Article
{Title}: Tumor-infiltrating lymphocytes as a predictor of axillary and primary tumor pathological response after neoadjuvant chemotherapy in patients with breast cancer: a retrospective cohort study.
{Author}: Chin K;Landén AH;Kovács A;Wärnberg F;Ekholm M;Karlsson P;Olofsson Bagge R;
{Journal}: Breast Cancer Res Treat
{Volume}: 0
{Issue}: 0
{Year}: 2024 May 4
{Factor}: 4.624
{DOI}: 10.1007/s10549-024-07334-6
{Abstract}: <B>OBJECTIVE: </B>Tumor-infiltrating lymphocytes (TILs) can predict complete pathological response (pCR) of tumor in the breast but not so well-defined in the axilla after neoadjuvant chemotherapy. Since axillary surgery is being increasingly de-escalated after NACT, we aimed to investigate the relationship between TILs and pCR in the axilla and breast, as well as survival amongst NACT patients.<BR><B>METHODS: </B>Clinicopathological data on patients who underwent NACT between 2013 and 2020 were retrospectively examined. Specifically, pre-TILs (before NACT), post-TILs (after NACT) and ΔTIL (changes in TILs) were assessed. Primary endpoint was pCR and secondary endpoints were breast cancer-free interval (BCFI) and overall survival (OS).<BR><B>RESULTS: </B>Two hundred and twenty patients with nodal metastases were included. Overall axillary and breast pCR rates were 42.7% (94/220) and 39.1% (86/220), respectively, whereas the combined pCR rate was 32.7% (72/220). High pre-TILs (OR 2.03, 95% CI 1.02-4.05; p = 0.04) predicted axillary pCR whereas, high post-TILs (OR 0.33, 95% CI 0.14-0.76; p = 0.009) and increased ΔTILs (OR 0.25, 95% CI 0.08-0.79; p = 0.02) predicted non-axillary pCR. TILs were not a significant predictor for BCFI and OS.<BR><B>CONCLUSIONS: </B>This study supports the potential use of pre-TILs to select initially node-positive patients for axillary surgical de-escalation after NACT.