Neoadjuvant letrozole for postmenopausal estrogen receptor-positive, HER2-negative breast cancer patients, a study from the Danish Breast Cancer Cooperative Group (DBCG)
Signe Korsgaard Skriver
Anne-Vibeke Laenkholm
Birgitte Bruun Rasmussen
Jürgen Handler
Bo Grundtmann
Tove Filtenborg Tvedskov
Peer Christiansen
Ann S. Knoop
Maj-Britt Jensen
Bent Ejlertsen
10.6084/m9.figshare.5630116
https://tandf.figshare.com/articles/dataset/Neoadjuvant_letrozole_for_postmenopausal_estrogen_receptor-positive_HER2-negative_breast_cancer_patients_a_study_from_the_Danish_Breast_Cancer_Cooperative_Group_DBCG_/5630116
<p><b>Introduction:</b> Neoadjuvant endocrine treatment (NET) is a low-toxicity approach to achieve operability in locally advanced breast cancer, and to facilitate breast conservation in early breast cancer, particular in patients with highly estrogen receptor (ER) positive and HER2-negative disease. Here, we report the results obtained by neoadjuvant letrozole in patients with early breast cancer in a phase-II design.</p> <p><b>Material and methods:</b> A total of 119 postmenopausal women with ER-positive, HER2-negative operable breast cancer were assigned to four months of neoadjuvant letrozole before definitive surgery. Sentinel node or diagnostic fine needle aspiration cytology procedure was performed prior to treatment and the women were assessed prior, at two months, and before surgery with clinical examination, mammography and ultrasonography. Surgical specimens were examined for pathological response. Primary outcome was pathological and clinical response.</p> <p><b>Results:</b> The per protocol population consisted of 112 patients. Clinical response was evaluated in 109 patients and pathological response in 108. Overall a mean decrease in tumor size was 15% (<i>p</i> ≤ .0001). One patient had complete pathological response and 55% of patients had partial pathological response. ER at 100%, ductal subtype, tumor size below 2 cm and lymph node–negative status was significantly associated with a better response to NET and malignancy grade 3 with a poorer response to NET. One patient progressed during treatment and received neoadjuvant chemotherapy. Eight patients received adjuvant chemotherapy due to lack of response.</p> <p><b>Conclusion:</b> Neoadjuvant aromatase inhibitor therapy is an acceptable strategy in selected postmenopausal patients with ER-rich and HER2-negative early breast cancer with ductal histology and should be considered when chemotherapy either isn’t indicated or feasible.</p>
2017-11-23 13:13:15
needle aspiration cytology procedure
tumor size
postmenopausal estrogen receptor-positive
119 postmenopausal women
HER 2-negative disease
HER 2-negative
Neoadjuvant aromatase inhibitor therapy
DBCG
breast cancer
HER 2-negative breast cancer patients
Danish Breast Cancer Cooperative Group
neoadjuvant letrozole
malignancy grade 3
response