News & Perspective

HKBCR Report: Neoadjuvant chemotherapy effective in downsizing tumors

Oncology
14 days ago, OP Editor

The Hong Kong Breast Cancer Registry (HKBCR) is a project operated by the Hong Kong Breast Cancer Foundation (HKBCF), aiming to collect and analyze the local population-wide breast cancer data.1 Since its establishment, the registry is increasingly recognized as an effective surveillance tool for breast cancer cases in Hong Kong.1 Below are selected data from the HKBCR Report No. 9 (Issue 2017), supplemented by the sub-analysis on neoadjuvant chemotherapy (NAC) use.1,2

Based on the latest HKBCR report, Dr. Polly Cheung, Chairman of HKBCR Steering Committee, concluded that “54% of the Hong Kong breast cancer patients were diagnosed with stage II or above [Figure 1]. More than 80% of them received chemotherapy as part of their cancer treatment.”1,3

News#7-100On the other hand, the hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-positivity of breast cancers in Hong Kong were also reported.1 For invasive breast cancers (n=11,916), 80.2% were HR-positive (defined as either estrogen receptor [ER] or progesterone receptor [PR] positive) and 21.2% were HER2-positive (defined as immunohistochemistry [IHC] score 3 and/or a positive result by in situ hybridization [ISH]).1 For in situ breast cancers (n=1,929), 82.1% and 27.1% were HR-positive and HER2-positive, respectively.1

The HKBCF also released a separate report on the use of neoadjuvant chemotherapy (NAC) and its effectiveness in the management of Hong Kong breast cancer patients.2,3 The sub-analysis assessed 928 of 12,729 women diagnosed with invasive breast cancer between 2006 and 2015, who received chemotherapy in the neoadjuvant settings. “The aim of NAC is to shrink the tumor in the breast, and kill any other breast cancer cells that may be present elsewhere in the body.“ said Dr. Carol Kwok, HKBCR Steering Committee member.2,3

Remarkably, almost half (48.6%) of patients with HR-negative HER2-positive breast cancers achieved pathological complete responses (pCR) after receiving NAC.2,3 The report noted that, “multivariate analysis found that the significant factors that were favorable to pCR included PR-negativity and HER2-positivity. Other factors, including age, menopausal age, clinical tumor and nodal stages, ER status, and Ki-67 proliferation index were not associated with pCR.”2 Overall, 19.4% of all patients achieve pCR in the breast and axillary lymph node.2

It was also found that higher proportions of clinically stage IIA or IIB patients underwent breast conserving surgery (BCS) after being treated with NAC (52.9% and 41.2%, respectively).2 Yet, even in those with clinically stage III diseases, 14.4% of them were still able to undergo BCS after NAC.2

“Neoadjuvant chemotherapy is a new hope for women with breast cancer. It has been proven to be able to facilitate the surgical approach in treating breast cancer, either by converting an inoperable cancer to one that is operable, or by converting a candidate for mastectomy to one who might be treated successfully with breast-conserving therapy.” said Dr. Kwok.3

 

 

  1. Hong Kong Breast Cancer Registry Report No. 9. Issue 2017 (Accessed December 29, 2017, at http://www.hkbcf.org/data.php?aid=113&did=212&lang=eng).
  2. HKBCR Bulletin. Neoadjuvant Chemotherapy Induces Tumour Size Reduction and Enables Breast-Conserving Surgery in Hong Kong Breast Cancer Patients. September 2017 Issue 8 (Accessed December 29, 2017, at https://www.hkbcf.org/download/bcr_report9/2017BCR_Bulletin_09_eng.pdf).
  3. Ask After Diagnosis A New Trend in Breast Cancer Treatment: Neoadjuvant Chemotherapy Can Reduce Tumour Size and The Need for Mastectomy. HKBCF Press Release 2017 (Accessed December 29, 2017, at https://hkbcf.org/download/press/20170927_pressRelease_Eng.pdf).

Tags

Menu Section