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  • br Figure Association between oncologic outcomes and status

    2020-03-24


    Figure 1 Association between oncologic outcomes and status of Doxorubicin receptor (ER) in patients undergoing neoadjuvant chemotherapy. Local recurrence (A, D); distant metastasis (B, E); and overall survival (C, F) according to the status of ER before and after neoadjuvant chemotherapy.
    Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
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    Absence of ER in breast cancer
    Table 4 Associations between oncologic outcomes and status of biomarkers in patients with breast cancer who underwentneoadjuvant chemotherapy.
    Locoregional Distant Expired
    Locoregional Distant Expired
    receptor
    breast cancer
    Figure 2 Association between oncologic outcomes and status of progesterone receptor (PR) in patients undergoing neoadjuvant chemotherapy. Local recurrence (A, D); distant metastasis (B, E); and overall survival (C, F) according to the status of PR before and after neoadjuvant chemotherapy.
    Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
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    markers after NAC in breast cancer were not directly associated with any oncologic events (Table 5).
    4. Discussion
    Breast cancer is very heterogeneous disease with different treatment modalities and prognoses, depending on the subtype of breast cancer. Therefore, the evaluation of the initial subtype of breast cancer may be crucial in deter-mining the appropriate treatment modalities and evalu-ating prognosis, especially in locally advanced breast cancer, which needs NAC.
    The response of HER2 (þ) or TNBC to NAC is more sig-nificant than that of ER (þ), HER2 ( ) breast cancer.15,16 Because of these lower response rates of ER (þ), HER2 ( ) breast cancer, other neoadjuvant treatments, including endocrine treatment, are suggested for locally advanced,
    hormone receptor positive breast cancer.17,18 However, hormone receptor positive breast cancer shows better prognosis, even if the rate of pCR is lower than that of hormone receptor-negative or TNBC.
    Discordance rates of the ER, PR, and HER2 gene between before and after NAC are separately different, even in same breast cancer.14 And several studies have reported that changes in molecular biomarkers, including PR or Ki67 index, have prognostic roles in breast cancer patients who underwent NAC and have residual disease.19e21 Initially, the authors also tried to prove that the change of biomarkers may be associated with oncologic outcomes in patients with locally advanced breast cancer who needs NAC. However, in a recent study, no statistical significance between changes in biomarkers and oncologic results was observed. Nevertheless, we found that other important result that the absence of ER before and after NAC was both associated in locoregional recurrence and distant metastasis. As previ-
    Figure 3 Association between oncologic outcomes and status of HER2 gene in patients undergoing neoadjuvant chemotherapy. Local recurrence (A, D); distant metastasis (B, E); and overall survival (C, F) according to the status of HER2 gene before and after neoadjuvant chemotherapy.
    Please cite this article as: Park YR et al., Absence of estrogen receptor is associated with worse oncologic outcome in patients who were received neoadjuvant chemotherapy for breast cancer, Asian Journal of Surgery, https://doi.org/10.1016/j.asjsur.2019.05.010
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    Absence of ER in breast cancer 7
    Figure 4 Association between oncologic outcomes and status of triple negative breast cancer (TNBC) in patients undergoing neoadjuvant chemotherapy Local recurrence (A, D); distant metastasis (B, E); and overall survival (C, F) according to the status of TNBC before and after neoadjuvant chemotherapy.