新辅助治疗后腋窝病理学完全缓解的预测因素及其在HER2阳性、初始淋巴结阳性乳腺癌中的预后价值

TL;DR - A WeChat summary of a multicenter retrospective study (Medicina, 221 patients) on HER2-positive, biopsy-confirmed node-positive breast cancer, identifying predictors of axillary pathological complete response (ApCR) after trastuzumab-based neoadjuvant therapy and its prognostic value. Note: this item is clinical oncology, with no AI/ML component.

• Response rates: ApCR 67.9%, breast pCR 53.4%, overall pCR 51.1%; cohort was 92.3% invasive ductal, 63.3% HR-positive, 88.35% HER2 IHC 3+, 64.7% stage III, and 71% received dual HER2 blockade (trastuzumab + pertuzumab).
• Multivariate logistic regression found two independent ApCR predictors: clinical stage II vs III (OR 2.251; 95% CI 1.182–4.287; p=0.014) and HER2 IHC 3+ vs IHC 2+/FISH+ (OR 2.745; 95% CI 1.138–6.619; p=0.025).
• Survival (median follow-up 34.3 months, 28 recurrences, 14 deaths): 3-year EFS 92% with ApCR vs 75% without (p=0.001); 3-year OS 96% vs 86% was not significant (p=0.063), likely underpowered by few events.
• Practice gap: sentinel lymph node biopsy was used in only 36% of ApCR patients (29.4% overall), suggesting surgical de-escalation lags behind response rates; limitations include retrospective design, short follow-up, and a small IHC 2+/FISH+ subgroup.