Đánh giá đáp ứng lâm sàng và mô bệnh học ở bệnh nhân ung thư vú giai đoạn III điều trị tân bổ trợ và phẫu thuật tại Bệnh viện K

Abstract

Objective: To evaluate the clinical and pathological responses in stage III breast cancer patients treated with neoadjuvant therapy (NAT). Subject and method: A retrospective and prospective study on 250 patients at the Breast Surgery Department, Vietnam National Cancer Hospital, from August 2021 to June 2024. Clinical response was assessed using RECIST 1.1, and pathological response was evaluated according to Chevallier, Sataloff, Miller-Payne, and Residual Cancer Burden (RCB) criteria. Result: The most patient was under 50 years old (52%). The distribution of stages IIIA, IIIB, and IIIC were 32%, 46.8%, and 21.2%, respectively. Most histopathological diagnoses were invasive carcinoma of no special type (NST) (83.2%), with grade II accounting for 44.8%. The major molecular subtypes were Luminal B (55.6%) and HER2+ (41.2%). A total of 82% of patients received anthracycline-based regimens, with 44% on a dose-dense regimen, and 81.6% completing 8 treatment cycles. Clinical complete response (CR) according to RECIST 1.1 was achieved in 18.8% of cases. Pathological complete response (pCR) rates according to TNM, Chevallier, Sataloff (Tumor and Node), Miller-Payne, and RCB were 18.4%, 28%, 52.8%, 21.6%, and 24.4%, respectively. The overall survival (OS) rate after 3 years was 98.8%, and events-free survival (EFS) was 93.2%. Conclusion: NAT significantly improved both clinical and pathological responses in stage III breast cancer patients, with a CR of 18.8% and a pCR of 24.4%. Survival rates are favorable, though long-term follow-up is necessary to assess the durability of these outcomes.