A simple system for grading the response of breast cancer to neoadjuvant chemotherapy.

Abstract

CONCLUSIONS

The NRI proposed here may be useful to better reflect the efficacy of neoadjuvant systemic regimens than the binary pCR-'no pCR' system.

BACKGROUND

The response of primary breast cancer to chemotherapy is usually expressed either as a pathological complete remission (pCR) or as 'no pCR'. A more quantitative measure is called for.

RESULTS

The NRI was calculated in 267 patients who had received neoadjuvant chemotherapy. The average NRI was 0.48 (median 0.40). Forty-one patients (15%) had an NRI of 0; 55 patients (21%) had an NRI of 1 (pCR). 'Highly endocrine responsive' tumors responded substantially less than 'incompletely endocrine responsive' ones. In triple negatives, an NRI of >0.70 was associated with a better recurrence-free survival than a lower NRI.

PATIENTS AND METHODS

The 'neoadjuvant response index' (NRI) was calculated by adding a breast response score (a number from a five-point scale) to an axillary response score (a number from a three-point scale) and dividing this by the score that would have been obtained in case of a pCR in both breast and axilla. Consequently, the NRI is a number between 0 (representing no response) and 1 (a pCR of both breast and axilla).

More about this publication

Annals of oncology : official journal of the European Society for Medical Oncology
  • Volume 21
  • Issue nr. 3
  • Pages 481-487
  • Publication date 01-03-2010

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