To evaluate the rate of early breast cancer (EBC) patients treated with neoadjuvant systemic therapy (NAT) in Italy, criteria of patient selection and types of therapies delivered, an analysis of 1276 patients with stage I-II-III was conducted out of 1633 patients enrolled in the multicenter prospective observational BRIDE study. A total of 177 patients (13.9%) were treated with NAT and 1099 (85.9%) with surgery; in multivariate analysis, menopausal status, cT, cN, grade, HER2-positive and Triple negative (TN) subgroups were significantly associated with the decision to administer NAT. The type of NAT delivered was influenced by EBC subtype. NAT was administered to 53.2% of HER2+/HR-negative, 27.9% of HER2+/HR+, 7.1% of HER2-negative/HR+ and 30.3% of TN EBC patients. The pCR rates were similar to the ones reported in the literature: 74.2% in HER2+/HR-negative, 52.3% in HER2+/HR+, 17.2% in HER2-negative/HR+ and 37.9% in TN. In clinical practice, patient and tumor characteristics influenced oncologists in the decision to administer NAT in EBC and in the choice of the type of systemic therapy, according to ESMO and AIOM Guidelines. Currently, it is recommended always to evaluate the use of NAT in EBC, mainly in HER2+ and TN patients, considering that pCR is associated with significantly better survival of the patient and that effective therapies are now available for residual disease.
为评估意大利早期乳腺癌患者接受新辅助全身治疗的比例、患者选择标准及所采用的治疗方案，本研究对多中心前瞻性观察性BRIDE研究入组的1633例患者中的1276例I-II-III期患者进行了分析。共有177例患者（13.9%）接受了新辅助治疗，1099例（85.9%）接受了手术治疗；多变量分析显示，绝经状态、临床T分期、临床N分期、肿瘤分级、HER2阳性及三阴性亚组与实施新辅助治疗的决定显著相关。所采用的新辅助治疗方案类型受早期乳腺癌亚型影响：53.2%的HER2+/HR阴性、27.9%的HER2+/HR阳性、7.1%的HER2阴性/HR阳性及30.3%的三阴性早期乳腺癌患者接受了新辅助治疗。病理完全缓解率与文献报道数据相近：HER2+/HR阴性组为74.2%，HER2+/HR阳性组为52.3%，HER2阴性/HR阳性组为17.2%，三阴性组为37.9%。临床实践中，根据欧洲肿瘤内科学会和意大利肿瘤医学协会指南，患者及肿瘤特征会影响肿瘤医生对早期乳腺癌患者实施新辅助治疗的决策及全身治疗方案的选择。鉴于病理完全缓解与患者生存期显著改善相关，且目前对残留病灶已有有效疗法，当前建议始终评估新辅助治疗在早期乳腺癌（尤其是HER2阳性及三阴性患者）中的应用价值。
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