ImpactU Versión 3.11.2 Última actualización: Interfaz de Usuario: 16/10/2025 Base de Datos: 29/08/2025 Hecho en Colombia
Complete pathological response in patients with Her2 breast cancer treated with neoadjuvant therapy in the Instituto de Cancerología Las Américas de Medellín between 2007-2020.
ABSTRACT: Introduction: Breast cancer represents the principal cause of death by cancer in women in Colombia . North American data report an improve in overall survival (OS) and disease-free survival (DFS) in recent years, comparing with results 10 years ago; These improvements are significant and maybe are in relation to better treatment strategies guided by immuno-histochemical sub-classification of the breast cancer . The role of the pathological response of the tumor to neoadjuvant therapy is an important tool , CTneoBC , showed improvements in DFS and OS in a patient with a complete pathological response in the breast and the axillae compared with patients with CPR only in the breast. Methods: Retrospective analysis of the patient attended between 2007-2020 in the “Instituto de Cancerologia Las Americas, Auna”, with the diagnosis of non-metastatic breast cancer Her2+/Luminal B2 and that received neoadjuvant chemotherapy. Results: Between 2007-2020, 467 patients were registered in the database. Mean age was 50 years, mean BMI was 26.9, the size of the lesion (in the pre neoadjuvant treatment evaluation) was 48mm, 29.6% presented without nodal involvement; 155 (32.3%) had ER and PR negative on IHC. Of the patients with the report of the proliferation index, 341 patients, 89% had a ki67>20%. Grade 1&2 (OR 0,5 IC 0,37-0,81, p:0,03), ER + (OR 0,65 IC 0,43-0,97, p:0,04), PR + (OR 0,44 IC 0,37-0,81, p:0,03), were statistically associated with low PCR rates, whereas Her2 strong positivity (3+) was associated with high PCR rates (OR 3.3; IC 1,3-8,35; p:0,013) The average five year overall survival was 79.1% (IC 73.5-83.6) with a median 35 months of follow up. In the group who achieved CPR, one hundred eighty four (91.5%, CI 95% 82.6-95.9) patients were alive at 5 years, instead 73.6% (CI 66.4-79.6) in non CPR group. Conclusions: In patients with breast cancer Her2+, grade 3, ER -, PR -, Her2 strong positivity (3+) and principally use of anti Her 2 neoadjuvant treatment was statistically associated with high PCR. Surgery window time was also associated with PCR rate. The PCR rate it’s associated with better long term results like overall survival.