Patient characteristics and EPN distribution.

<p>Patient characteristics and EPN distribution.</p

Univariate and multivariate analysis of prognostic factors.

<p>Univariate and multivariate analysis of prognostic factors.</p

Patient characteristics and EPN distribution.

<p>Patient characteristics and EPN distribution.</p

Cumulative dose, dose intensity and response rate.

<p>Cumulative dose, dose intensity and response rate.</p

Kaplan-Meier plots for TTF according to subtypes.

<p>Among the four subtypes, TTF was 10.0 months in the EPN group and 3.7 months in the non-EPN group in the luminal type (p = <0.001); 31.7 months in the EPN group and 17.5 months in the non-EPN group in the luminal-HER2 type (p = 0.270); 15.9 months in the EPN group and 9.5 months in the non-EPN group in the HER2 type (p = 0.029); and 6.1 months in the EPN group and 3.7 months in the non-EPN group of the triple negative type (p = 0.043).</p

The early onset of peripheral neuropathy might be a robust predictor for time to treatment failure in patients with metastatic breast cancer receiving chemotherapy containing paclitaxel

<div><p>Background</p><p>Paclitaxel plays a central role in chemotherapy for breast cancer. Peripheral neuropathy, a well-known toxicity with paclitaxel, may be of interest in predicting the efficacy of paclitaxel therapy for patients with metastatic breast cancer. We performed a retrospective analysis assessing whether the early occurrence of peripheral neuropathy (EPN) was a predictive marker for better efficacy in patients with metastatic breast cancer receiving chemotherapy containing paclitaxel.</p><p>Patients and methods</p><p>Between January 2000 and August 2008, we examined the records of 168 patients with metastatic breast cancer treated with paclitaxel in our hospital. EPN was defined as a symptom of Grade 2 or more during first three months of treatment. The overall response rate (ORR) and time to treatment failure (TTF) in each group were analyzed retrospectively.</p><p>Results</p><p>Of 168 patients with metastatic breast cancer who were treated with paclitaxel, EPN was documented in 101 patients (60.1%). The clinical benefit rate (CR, PR, and SD ≥ 6 months) was 72.3% in the EPN group and 49.3% in the non-EPN group (p = 0.002). The TTF of the EPN group (median 11.2 months, 95% CI: 9.5–12.9) was significantly longer than that of the non-EPN group (5.7 months, 95% CI: 4.6–6.8) (p<0.001). Multivariate analysis demonstrated that EPN (p<0.001), dose intensity of less than 70% (p<0.001), and the history of microtubule agents (p = 0.001) were the significant favorable prognostic factors for TTF.</p><p>Conclusion</p><p>The early onset of peripheral neuropathy might be a robust predictor for TTF in patients with metastatic breast cancer treated with paclitaxel.</p></div

Kaplan-Meier plots for TTF.

<p>The TTF of the EPN group (median 11.2 months, 95% CI; 9.15–12.9) was significantly longer than that of the non-EPN group (5.7 months, 95% CI; 4.6–6.8) in all patients.</p

Predictive Factors and Value of ypN+ after Neoadjuvant Chemotherapy in Clinically Lymph Node-Negative Breast Cancer

<div><p>Background</p><p>Pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) has been regarded as a surrogate endpoint for disease-free survival (DFS) and overall survival (OS) of patients with breast cancer. No consensus regarding the definition of pCR has been established; there are several definitions according to a variety of classifications. Eradication of cancer cells in both breast and lymph nodes has been better associated with improved prognosis than in the breast alone. Even in patients diagnosed as having clinically node-negative cancer before NAC, postoperative pathological examination often shows axillary lymph node metastases.</p><p>Patients and Methods</p><p>Of the 771 patients with breast cancer who underwent NAC in the Cancer Institute Hospital between January 2000 and May 2009, 146 patients preoperatively diagnosed as having node-negative breast cancer were retrospectively evaluated. We have made the definition of clinically lymph node-negative (N0) as follows: first, ultrasonography before NAC did not show any lymphadenopathy. Second, a cytological procedure confirmed negative study for each patient when ultrasonography suggested lymphadenopathy.</p><p>Results</p><p>The median observation period was 79.7 months, and the median age of the subjects was 51 years. Pathological examination at the time of the surgery showed lymph node metastases (ypN+) in 46 patients (31.5%). Histological therapeutic effects revealed ypT0/is in 9 patients (6.2%) and ypTinv in 137 (93.8%). Multivariate analysis demonstrated that younger age (49>), large tumor size, NG3, and ypN+ were significant poor prognostic factors for DFS (p = 0.020, p = 0.008, P = 0.022 and p = 0.010, respectively). Moreover, ypN+ was the only significant poor prognostic factor for OS (p = 0.022). The predictive factors of ypN+ in clinically lymph node–negative breast cancer were ypTinv (p = 0.036) and the luminal type (HR+ and HER2-) (p = 0.029).</p><p>Conclusion</p><p>The prognosis of clinically lymph node negative breast cancer depended on ypN+, which was associated with ypTinv and luminal subtype.</p></div

Study profile.

<p>Study profile.</p

The predictive factors of ypN+ in N0 breast cancer.

<p>The predictive factors of ypN+ in N0 breast cancer.</p