Factors influencing pathological complete response and tumor regression in neoadjuvant radiotherapy and chemotherapy for high-risk breast cancer

Haussmann, Jan; Budach, Wilfried; Nestle-Krämling, Carolin; Wollandt, Sylvia; Jazmati, Danny; Tamaskovics, Bálint; Corradini, Stefanie; Bölke, Edwin; Haussmann, Alexander; Audretsch, Werner; Matuschek, Christiane

doi:10.1186/s13014-024-02450-5

Table 2 Rates of pathological complete response (ypT0/Tis ypN0) and breast pathological complete response (yT0/Tis) between different subgroups with the corresponding 95%-confidence intervals

From: Factors influencing pathological complete response and tumor regression in neoadjuvant radiotherapy and chemotherapy for high-risk breast cancer

Pathological complete response (ypT0/Tis ypN0)
Subgroup	n Non-pCR	N pCR	Rate	CI—95% low	CI—95% high
All	235	106	0.31	0.26	0.36
Age
Age < 45y	39	27	0.41	0.29	0.53
Age 45y − 55y	90	39	0.30	0.22	0.38
Age > 55y	106	40	0.27	0.20	0.35
Resection type
Breast conserving surgery	106	68	0.39	0.32	0.46
Mastectomy	129	38	0.23	0.16	0.29
Side breast cancer
Right	107	47	0.31	0.23	0.38
Left	115	51	0.31	0.24	0.38
Unknown	13	8	0.38	0.17	0.59
Biological subtype
Luminal A	44	8	0.15	0.06	0.25
Luminal B	121	41	0.25	0.19	0.32
HR + HER2 +	18	7	0.28	0.10	0.46
HR − HER2 +	13	10	0.43	0.23	0.64
Triple negative	30	25	0.45	0.32	0.59
Unknown	9	15	0.63	0.43	0.82
Histology
Ductal	158	79	0.33	0.27	0.39
Ductal/lobular	1	1	0.50	− 0.19	1.19
Lobular	49	17	0.26	0.15	0.36
Other	9	2	0.18	− 0.05	0.41
Unknown	18	7	0.28	0.10	0.46
Clinical tumor stage
cT1	0	3	1.00	1.00	1.00
cT2	66	45	0.41	0.31	0.50
cT3	110	39	0.26	0.19	0.33
cT4	59	19	0.24	0.15	0.34
Clinical nodal status
cN0	116	55	0.32	0.25	0.39
cN +	119	51	0.30	0.23	0.37
Stage
I	0	1	1.00	1.00	1.00
IIA	41	25	0.38	0.26	0.50
IIB	78	43	0.36	0.27	0.44
IIIA	56	18	0.24	0.15	0.34
IIIB	59	19	0.24	0.15	0.34
IIIC	1	0	0.00	0.00	0.00
Tumor grade
G1	20	4	0.17	0.02	0.32
G2	101	37	0.27	0.19	0.34
G3	114	65	0.36	0.29	0.43
Growth pattern
Unifocal	178	81	0.31	0.26	0.37
Multifocal	17	10	0.37	0.19	0.55
Multicentric	30	10	0.25	0.12	0.38
Unknown	10	5	0.33	0.09	0.57
Interval radiotherapy to resection
< Median time	121	45	0.27	0.20	0.34
> Median time	114	61	0.35	0.28	0.42
Dose to tumorbed (EQD2 (3.7))
< 60 Gy (Median)	43	15	0.26	0.15	0.37
> 60 Gy (Median)	185	89	0.32	0.27	0.38
Unknown	7	4	0.36	0.08	0.65
Dose to tumorbed (EQD2 (3.7))
< 64 Gy (Mean)	156	71	0.31	0.25	0.37
> 64 Gy (Mean)	72	33	0.31	0.23	0.40
Unknown	7	4	0.36	0.08	0.65
Regional nodal irradiation
No RNI	27	19	0.41	0.27	0.56
Any RNI	208	87	0.29	0.24	0.35
No RNI	27	19	0.41	0.27	0.56
L3 − 4	164	65	0.28	0.23	0.34
L3 − 4 + IMN	29	11	0.28	0.14	0.41
IMN	4	5	0.56	0.23	0.88
Unknown	11	6	0.35	0.13	0.58
Type of breast radiotherapy
Photon	125	54	0.30	0.23	0.37
Cobalt	107	49	0.31	0.24	0.39
Unknown	3	3	0.50	0.10	0.90
Type of boost
Brachytherapy	69	30	0.30	0.21	0.39
Cobalt	17	2	0.11	− 0.03	0.24
Photon	23	12	0.34	0.19	0.50
Electron	102	51	0.33	0.26	0.41
Mixed	11	1	0.08	− 0.07	0.24
Unknown	13	9	0.41	0.20	0.61
No Boost	0	1	1.00	1.00	1.00
Neoadjuvant chemotherapy
None	14	1	0.07	− 0.06	0.19
Standard	65	33	0.34	0.24	0.43
Substandard	156	72	0.32	0.26	0.38
Neoadjuvant chemotherapy
None	14	1	0.07	− 0.06	0.19
EC/AC + CMF	50	32	0.39	0.28	0.50
4 × EC/AC + Taxan	10	1	0.09	− 0.08	0.26
3 drug combination	5	0	0.00	0.00	0.00
Mitoxantron	62	35	0.36	0.27	0.46
4 − 6 × EC	81	32	0.28	0.20	0.37
AC/EC + Mitoxantron	1	1	0.50	− 0.19	1.19
CMF + Mitoxantron	6	0	0.00	0.00	0.00
CMF	3	1	0.25	− 0.17	0.67
Other	3	3	0.50	0.10	0.90
Neoadjuvant chemotherapy
None	14	1	0.07	− 0.06	0.19
No Anthracycline or Taxane	82	40	0.33	0.24	0.41
Anthracycline, no Taxane	140	64	0.31	0.25	0.38
Anthracycline and Taxane	12	3	0.20	0.00	0.40
Induction endocrine therapy
No endocrine therapy	47	29	0.38	0.27	0.49
Induction endocrine therapy	112	46	0.29	0.22	0.36
Adjuvant endocrine therapy	63	22	0.26	0.17	0.35
Unknown	13	9	0.41	0.20	0.61

Breast pathological complete response (ypT0/Tis)
Subgroup	N	N	Rate	CI—95% low	CI—95% high
Subgroup	Non-bpCR	bpCR	Rate	CI—95% low	CI—95% high
All	208	133	0.39	0.34	0.44
Age
Age < 45y	30	36	0.55	0.43	0.67
Age 45 y–55 y	80	49	0.38	0.30	0.46
Age > 55 y	98	48	0.33	0.25	0.40
Resection type
Breast conserving surgery	93	81	0.47	0.39	0.54
Mastectomy	115	52	0.31	0.24	0.38
Side breast cancer
Right	90	64	0.42	0.34	0.49
Left	106	60	0.36	0.29	0.43
Unknown	12	9	0.43	0.22	0.64
Biological subtype
Luminal A	44	8	0.15	0.06	0.25
Luminal B	110	52	0.32	0.25	0.39
HR + HER2 +	16	9	0.36	0.17	0.55
HR − HER2 +	8	15	0.65	0.46	0.85
Triple Negative	22	33	0.60	0.47	0.73
Unknown	8	16	0.67	0.48	0.86
Histology
Ductal	138	99	0.42	0.35	0.48
Ductal/Lobular	1	1	0.50	− 0.19	1.19
Lobular	45	21	0.32	0.21	0.43
Other	8	3	0.27	0.01	0.54
Unknown	16	9	0.36	0.17	0.55
Clinical tumor stage
cT1	0	3	1.00	1.00	1.00
cT2	58	53	0.48	0.38	0.57
cT3	95	54	0.36	0.29	0.44
cT4	55	23	0.29	0.19	0.40
Clinical nodal status
cN0	105	66	0.39	0.31	0.46
cN +	103	67	0.39	0.32	0.47
Stage
I	0	1	1.00	1.00	1.00
IIA	37	29	0.44	0.32	0.56
IIB	67	54	0.45	0.36	0.53
IIIA	48	26	0.35	0.24	0.46
IIIB	55	23	0.29	0.19	0.40
IIIC	1	0	0.00	0.00	0.00
Tumor grade
G1	20	4	0.17	0.02	0.32
G2	94	44	0.32	0.24	0.40
G3	94	85	0.47	0.40	0.55
Growth pattern
Unifocal	159	100	0.39	0.33	0.45
Multifocal	14	13	0.48	0.29	0.67
Multicentric	26	14	0.35	0.20	0.50
Unknown	9	6	0.40	0.15	0.65
Interval radiotherapy to resection
< Median time	108	58	0.35	0.28	0.42
> Median time	100	75	0.43	0.36	0.50
Dose to tumorbed (EQD2 (3.7))
< 60 Gy (Median)	37	21	0.36	0.24	0.49
> 60 Gy (Median)	165	109	0.40	0.34	0.46
Unknown	6	3	0.33	0.03	0.64
Dose to tumorbed (EQD2 (3.7))
< 64 Gy (Mean)	143	84	0.37	0.31	0.43
> 64 Gy (Mean)	59	46	0.44	0.34	0.53
Unknown	6	3	0.33	0.03	0.64
Regional nodal irradiation
No RNI	26	20	0.43	0.29	0.58
Any RNI	182	113	0.38	0.33	0.44
No RNI	26	20	0.43	0.29	0.58
L3 − 4	147	82	0.36	0.30	0.42
L3 − 4 + IMN	24	16	0.40	0.25	0.55
IMN	2	7	0.78	0.51	1.05
Unknown	9	8	0.47	0.23	0.71
Type of breast radiotherapy
Photon	114	65	0.36	0.29	0.43
Cobalt	92	64	0.41	0.33	0.49
Unknown	2	4	0.67	0.29	1.04
Type of boost
Brachytherapy	57	42	0.42	0.33	0.52
Cobalt	16	3	0.16	− 0.01	0.32
Photon	20	15	0.43	0.26	0.59
Electron	92	61	0.40	0.32	0.48
Mixed	11	1	0.08	− 0.07	0.24
Unknown	12	10	0.45	0.25	0.66
No Boost	0	1	1.00	1.00	1.00
Neoadjuvant chemotherapy
None	13	2	0.13	− 0.04	0.31
Standard	54	44	0.45	0.35	0.55
Substandard	141	87	0.38	0.32	0.44
Neoadjuvant chemotherapy
None	13	2	0.13	− 0.04	0.31
EC/AC + CMF	39	43	0.52	0.42	0.63
4 × EC/AC + Taxan	10	1	0.09	− 0.08	0.26
3 drug combination	5		0.00	0.00	0.00
Mitoxantron	54	43	0.44	0.34	0.54
4 − 6 × EC	77	36	0.32	0.23	0.40
AC/EC + Mitoxantron	1	1	0.50	− 0.19	1.19
CMF + Mitoxantron	5	1	0.17	− 0.13	0.46
CMF	1	3	0.75	0.33	1.17
Other	3	3	0.50	0.10	0.90
Neoadjuvant chemotherapy
None	13	2	0.13	− 0.04	0.31
No Anthracycline or Taxane	60	49	0.45	0.36	0.54
Anthracycline, no Taxane	123	79	0.39	0.32	0.46
Anthracycline and Taxane	12	3	0.20	0.00	0.40
Induction endocrine therapy
No endocrine therapy	37	39	0.51	0.40	0.63
Induction endocrine therapy	103	55	0.35	0.27	0.42
Adjuvant endocrine therapy	56	29	0.34	0.24	0.44
Unknown	12	10	0.45	0.25	0.66

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