ReviewBreast cancer research and treatment2024
Nodal pCR and overall survival following neoadjuvant chemotherapy for node positive ER+/Her2- breast cancer.
Review in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Prognostic value of platelet to lymphocyte ratio (PLR) in breast cancer patients receiving neoadjuvant therapy: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Lack of Utility of Ki-67 in Axillary Surgical Planning and Prognostication after Neoadjuvant Chemotherapy for Node-Positive Breast Cancer.Annals of surgical oncology · 2026Article
- Neoadjuvant Dual-Targeted HER2 Therapy and Neoadjuvant Chemo-Immunotherapy is Associated with Improved Nodal pCR and Reduced Axillary Surgery.Annals of surgical oncology · 2026Article
- Axillary Management in Clinically Node-Positive (cN1) Estrogen Receptor-Positive Breast Cancer.Cancers · 2026Article
- Low-progesterone receptor expression predicts nodal pathological complete response after neoadjuvant chemotherapy in premenopausal patients with ER-positive/HER2-negative breast cancer.Breast cancer (Tokyo, Japan) · 2026Article
- Multimodal radiomics for early prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer: integration of amide proton transfer weighted imaging in radiomics.BMC medical imaging · 2026Article
- Article
- The landscape of dynamic tumor immunophenotyping on neoadjuvant chemotherapy combined with trastuzumab for the treatment of HER2-positive breast cancer.Molecular cancer · 2025Article
- Survival outcomes after pathologic complete response with neoadjuvant endocrine therapy vs. neoadjuvant chemotherapy: a retrospective national database study.Breast cancer research and treatment · 2025Article
- Personalized multifactorial risk assessment in neoadjuvant-treated breast carcinoma.Breast cancer research and treatment · 2025Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe role of neoadjuvant chemotherapy (NAC) in node-positive (N+) ER+/HER2- breast cancer (BC) is debated, given low total pathologic complete response (pCR) rates. However, the rate and impact of nodal pCR is unknown. We sought to evaluate nodal pCR rates and the impact on overall survival (OS). Further, we sought to validate the association between nodal pCR with age and Ki67.
methodsWe queried the National Cancer Database for cN + ER+/HER2- BC patients treated with NAC and surgery. Data from 2010 to 2018 were used to evaluate nodal pCR and OS, with multivariable Cox proportional hazards modeling for OS, as well as Ki67 for the years 2018-2019.
resultsFrom 2010 to 2018, we identified 19,611 cN + ER+/HER2- BC patients treated with NAC. While total pCR occurred in only 7.4%, nodal pCR rates were nearly double (14.3%). Nodal pCR (+/- breast pCR) was seen in 21.7% and associated with 5-year OS rate of 86.1% (95% CI: 84.9-87.4%) versus 77.1% (95% CI: 76.3-77.9%) in patients without nodal pCR (p < 0.001). On multivariable analysis, nodal pCR had better OS (adjusted HR 0.57, 95% CI 0.52-0.63, p < 0.001) across all age groups. Of 2,444 patients with available Ki67, those with age < 50 and Ki67 ≥ 20% had the highest nodal pCR at 31.6%.
conclusionIn cN + ER+/HER2- BC treated with NAC, nodal pCR is common, associated with age and Ki67, and prognostic for OS. These data strongly suggest that for cN + patients, eradication of nodal disease is critical for OS, and total pCR may not be the optimal measure of NAC benefit.
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