Abstract P2-11-15: Axillary Pathologic Complete Response in Triple-Negative Breast Cancer Patients with Mammary Pathologic Complete Response: A Systematic Review
Notice bibliographique
Résumé
Abstract Background: Neoadjuvant chemotherapy plays a crucial role in breast cancer by providing prognostic information through assessment of systemic treatment response. Response patterns can indicate which patients may have better survival outcomes and may benefit from less invasive therapies. Considering mammary and axillary responses, patients with HER2-positive and triple-negative subtypes exhibit higher rates of pathologic complete response (pCR). This study aimed to evaluate the rate of axillary pCR in triple-negative breast cancer patients achieving mammary pCR. Methods: This systematic review was conducted following the PRISMA protocol and was registered in PROSPERO (ID: 498121). PubMed, Embase, and Web of Science databases were searched. MESH Terms used were: ((((triple negative breast cancer) and (neoadjuvant chemotherapy)) and (lymph node)) and (axilla response)) and (breast response). Article screening was performed independently by two evaluators using the Rayyan platform. Pathologic complete response (pCR) was defined as the absence of invasive disease in the breast and axilla, with or without residual in situ disease after neoadjuvant chemotherapy (ypT0/ypTis/ypN0). Axillary pCR also included the absence of isolated tumor cells and micrometastases. Studies evaluating mammary and axillary pCR after neoadjuvant treatment in breast cancer patients, including triple-negative tumors, were included without restrictions on chemotherapy type or surgical procedures. Methodological quality assessment was conducted using the Newcastle-Ottawa Scale for cohort studies. Results: As of November 2023, 180 studies were retrieved, with ten cohort studies meeting the inclusion criteria, totaling 7,206 patients, of whom 30% had triple-negative tumors. Each of the 10 pre-selected articles, all cohort studies, underwent bias assessment using the Newcastle-Ottawa Scale. All 10 selected articles scored 6 or higher, indicating acceptable quality in their methodology and enabling inclusion in this systematic review. Among these, 42% had clinically positive axilla (cN+) prior to neoadjuvant chemotherapy, confirmed by cytologic examination in 419 cases and clinical or pathological examination in 2,575 cases. Axillary pCR rates were consistently higher than mammary pCR rates across the studies. In 9 out of the 10 selected articles, the rate of axillary pCR was higher than the rate of mammary pCR; in one of them, the rate was similar. In none of the evaluated articles was the mammary response rate higher than the axillary. The overall rates of pCR were 33.4% in the breast (ranging from 19 to 48%), 49.3% in the axilla (ranging from 25 to 92%), and 26.9% (ranging from 14 to 38%) for both sites combined in the triple-negative population. Conclusion: Despite high chemosensitivity in triple-negative breast cancer, rates of mammary pCR are consistently lower than the rates of axillary pCR. Factors beyond tumor subtype likely influence response patterns, indicating the need for further research to identify predictive biomarkers and optimize treatment strategies. Citation Format: Deize Azevedo Pereira, Milena Martello Cristófalo, Jonathan Yugo Maesaka, Yedda Nunes Reis, Gabriela Bezerra Nóbrega, José Maria Soares-Jr, Edmund Chada Baracat, José Roberto Filassi. Axillary Pathologic Complete Response in Triple-Negative Breast Cancer Patients with Mammary Pathologic Complete Response: A Systematic Review [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-11-15.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,048 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,010 |
| Bibliométrie | 0,010 | 0,011 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».