ArticleRevista da Associacao Medica Brasileira (1992)2026
Independent prognostic ımpact of perineural ınvasion in breast cancer patients with residual disease after neoadjuvant chemotherapy.
Article in Revista da Associacao Medica Brasileira (1992), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePerineural invasion is a well-established adverse prognostic factor in several malignancies, yet its prognostic role in breast cancer remains controversial.
methodsWe retrospectively analyzed 400 breast cancer patients treated with neoadjuvant chemotherapy between 2012 and 2025 who had residual disease (non-pCR) at surgery. Clinicopathological variables, recurrence-free survival, and overall survival were evaluated using Cox proportional hazards models.
resultsPerineural invasion was identified in 42.5% of the cohort and associated with larger tumor burden, lymphovascular invasion, and nodal metastasis (p<0.01). Perineural invasion-positive status correlated with significantly inferior median recurrence-free survival (100.5 vs. 120.4 months; HR 1.77, p=0.008) and overall survival (108.5 vs. 133.6 months; HR 3.11, p<0.001). Multivariate analysis confirmed perineural invasion as a robust independent predictor of shorter recurrence-free survival and overall survival. The adverse impact was evident across all molecular subtypes, particularly HR+/HER2- and HER2+ groups.
conclusionPerineural invasion is a strong independent prognostic factor for recurrence-free survival and overall survival in breast cancer patients with residual disease after neoadjuvant chemotherapy. Reporting perineural invasion status in routine pathology evaluations may aid in risk stratification for this high-risk population.
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