Backgrounds: The majority of breast cancer (BC) patients treated with neo-adjuvant chemotherapy (NAC) achieves a pathologic partial response with different patterns of residual disease. No clear correlation between these patterns and oncological results was described. Our aims were to define the predictive factors for different patterns of residual disease and compare the outcomes between the scattered versus the circumscribed pattern. Methods: We reviewed 219 postoperative surgical specimens. Patients were divided into two groups: scattered versus circumscribed. Disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) were analyzed. Results: The scattered and circumscribed patterns were assessed in 111 (50.7%) and 108 (49.3%) patients. Two independent predictive factors for the circumscribed pattern were identified: discontinuation of NAC cycles (p= 0.011), and tumor size post-NAC >18 mm (p= 0.022). No difference was observed in terms of DFS and DDFS. Patients with the scattered pattern exhibited a statistically significant better OS. Discontinuation of NAC cycles, tumor size >18 mm, triple-negative BC, and ypN+ were associated with increased recurrence and poorer survival. Conclusions: Discontinuation of NAC cycles and tumor size are independent factors associated with patterns of residual disease. The scattered pattern presents better survival. Understanding the relationship between NAC, the residual pattern, and differences in survival outcomes offers the potential to optimize the therapeutic approaches.
背景：大多数接受新辅助化疗（NAC）的乳腺癌（BC）患者会达到病理部分缓解，但残留病灶呈现不同模式。目前尚无明确证据表明这些模式与肿瘤学结果存在关联。本研究旨在明确不同残留病灶模式的预测因素，并比较散在型与局限型模式之间的临床结局。 方法：我们回顾分析了219例术后手术标本。患者被分为两组：散在型与局限型。对无病生存期（DFS）、无远处转移生存期（DDFS）和总生存期（OS）进行分析。 结果：散在型与局限型模式分别见于111例（50.7%）和108例（49.3%）患者。研究确定了局限型模式的两个独立预测因素：NAC周期中断（p=0.011）和NAC后肿瘤大小>18 mm（p=0.022）。两组在DFS和DDFS方面未见显著差异。散在型模式患者的总生存期在统计学上显著更优。NAC周期中断、肿瘤大小>18 mm、三阴性乳腺癌以及新辅助化疗后淋巴结阳性（ypN+）与复发率升高和生存率降低相关。 结论：NAC周期中断和肿瘤大小是与残留病灶模式相关的独立因素。散在型模式患者生存预后更佳。深入理解新辅助化疗、残留模式与生存结局差异之间的关系，有望为优化治疗方案提供依据。
肿瘤(癌症)患者之家