ArticleIn vivo (Athens, Greece)
Combined Pathological Response and PEPI Score Improves Long-term Prognostic Stratification in HR-positive Breast Cancer Following Neoadjuvant Endocrine Therapy.
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Abstract
BACKGROUND/
aimNeoadjuvant endocrine therapy (NET) is increasingly used in hormone receptor (HR)-positive breast cancer; however, optimal methods for predicting long-term outcomes remain limited. This study aimed to evaluate the prognostic value of pathological response and preoperative endocrine prognostic index (PEPI), and to assess whether their combination improves risk stratification. PATIENTS AND
methodsA total of 160 postmenopausal patients with strongly HR-positive breast cancer (T1-3N0-1M0) treated with NET were retrospectively analyzed. Pathological response was assessed using the Miller & Payne grading system. PEPI scores were calculated based on post-treatment tumor characteristics. Survival outcomes, including relapse-free survival (RFS), distant disease-free survival (DDFS), and breast cancer-specific survival (BCSS), were analyzed.
resultsWith a median follow-up of 113 months, pathological response was independently associated with improved RFS, DDFS, and BCSS (all
conclusionThe integration of pathological evaluation with PEPI scoring provides a simple and clinically applicable approach for prognostic stratification in HR-positive breast cancer following NET. This combined model may help identify patients who could safely avoid adjuvant chemotherapy, supporting individualized treatment strategies.
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