br Surgery was recommended after considering the initial tum
Surgery was recommended after considering the initial tumor size, tumor stage, and treatment response. When the axillary lymph node was negative, sentinel lymph node biopsy was performed, even in cases wherein the metas-tasis of axillary lymph node was initially confirmed. How-ever, mastectomy was performed when the initial tumor
Table 1 Clinical factors of patients with breast cancer who underwent neoadjuvant chemotherapy.
Age at diagnosis of breast cancer (years)
Body mass index (kg/m )
Type of axillary surgery (n, %)
Axillary lymph nodes dissection 36 (63.2)
Please cite this article as: Park YR et al., Absence of CY7-SE receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
Absence of ER in breast cancer 3
size was >5 cm, even if the tumor appeared to have pathologic complete response (pCR).
After surgery, the four biomarkers were re-evaluated using surgical specimens, and further treatment, including adjuvant chemotherapy, radiotherapy, hormone treatment therapy, or targeted therapy, was determined on the basis of the biomarker evaluation. All the patients were followed up biannually after completing adjuvant treatments for the first 2 years and annually for another 3 years. Locoregional recurrence or distant metastasis was evaluated by blood testing, tumor marker tests, mammography, breast ultra-sonography, chest radiography, bone scans, and PET/CT.
Changes in biomarkers were compared between needle biopsy samples and surgical specimen obtained after NAC. The association between oncologic outcomes and bio-markers was analyzed.
2.1. Statistical analysis
All statistical analyses were performed using SPSS ver. 12.0 (SPSS, Chicago, IL, USA). Categorical variables were analyzed using the chi-squared test in univariate analysis, and oncologic outcomes were assessed using KaplaneMeier
Table 2 Clinical and pathological stages of patients with breast cancer who underwent neoadjuvant chemotherapy.
Before chemotherapy After chemotherapy p-value
Table 3 Changes in biomarkers of breast cancer before and after neoadjuvant chemotherapy.
Before chemotherapy After chemotherapy n Z 57
Progesterone receptor (n, %) Positive Positive 20 (35.1)
Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
analysis to identify factors affecting locoregional recur-rence or distant metastasis. The p-value<0.05 were considered to be statistically significant.
Of the 57 patients who underwent NAC for breast cancer, 14 (24.6%) underwent breast-conserving surgery, and 43 un-derwent mastectomy (75.4%). Axillary lymph node preser-vation surgery was performed in 21 cases (36.8%) and axillary lymph nodes dissection was performed in 36 cases (63.2%) of. Even if the NAC was completed before surgery, 30 patients (52.6%) with advanced breast cancer (>ypStage2B) were re-administered adjuvant chemo-therapy. Adjuvant radiotherapy and hormone treatment were administered in 47 (82.5%) and 40 (70.2%) cases of breast cancer, respectively.
Changes in biomarkers of breast cancer after NAC, including ER, PR, HER2 gene, triple negative status, and Ki67 index, are shown in Table 3. ER ( ) was strongly associated with locoregional recurrence and distant metastasis both before and after NAC (before p Z 0.021, 0.019; after p Z 0.018, 0.036) (Fig. 1). PR ( ) and TNBC before neoadjuvant chemotherapy were also associated with death and distant metastasis, respectively (Table 4, Figs. 2e5). However, unfortunately, the changes of bio-