{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:27:52Z","timestamp":1761514072925,"version":"3.37.3"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T00:00:00Z","timestamp":1505692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Background<\/jats:title>Neoadjuvant systemic therapy (NAST<\/jats:styled-content>) can be used to treat breast cancer. Pathologic complete response (pCR<\/jats:styled-content>) is a surrogate marker for improved survival. This study examined response in the breast and axilla to NAST<\/jats:styled-content> and identified features associated with pCR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients undergoing NAST<\/jats:styled-content> and surgery between January 2012 and June 2016 by surgeons at Westmead Breast Cancer Institute were identified. Patients with inflammatory or metastatic disease were excluded. Data were analysed to identify factors predictive of pCR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>Ninety\u2010one patients were identified. Mean age was 49 years. Forty\u2010one patients had axillary metastases identified prior to NAST<\/jats:styled-content>. Eighty\u2010three patients received chemotherapy alone, six endocrine therapy alone and two had both. Thirty\u2010seven patients had mastectomy and 54 had breast\u2010conserving surgery. The overall breast pCR<\/jats:styled-content> rate was 29% higher in patients with triple\u2010negative (50%) or HER2<\/jats:styled-content>\u2010positive (39%) disease and lower in luminal disease (11.6%, P<\/jats:italic> = 0.001). Forty percent of node\u2010positive patients became node negative. The only variable associated with pCR<\/jats:styled-content> was tumour biology. Patients with HER2<\/jats:styled-content>\u2010positive breast cancer were more likely to have axillary pCR<\/jats:styled-content> than those with luminal cancer (odds ratio: 28, P<\/jats:italic> = 0.00005).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>pCR<\/jats:styled-content> in either the breast or axilla was most likely to be achieved in patients with HER2<\/jats:styled-content>\u2010positive or triple\u2010negative breast cancers. In patients with luminal cancers, the goal of NAST<\/jats:styled-content> is best considered to facilitate surgical options rather than obtaining a pCR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14158","type":"journal-article","created":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T23:48:47Z","timestamp":1505778527000},"page":"640-644","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neoadjuvant systemic therapy for breast cancer: the W<\/scp>estmead experience"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-4176","authenticated-orcid":false,"given":"Annelise M.","family":"Cocco","sequence":"first","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Messer","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Sriram","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Department of Oncology, Macquarie University Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loma","family":"Al\u2010Mansouri","sequence":"additional","affiliation":[{"name":"Health Sciences Centre Macquarie University Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Kefford","sequence":"additional","affiliation":[{"name":"Health Sciences Centre Macquarie University Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farid","family":"Meybodi","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"French","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"},{"name":"Hospital for Specialist Surgery Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"},{"name":"Health Sciences Centre Macquarie University Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Surgery Westmead Hospital Sydney New South Wales Australia"},{"name":"Hospital for Specialist Surgery Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,9,18]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"CD005002","article-title":"Preoperative chemotherapy for women with operable breast cancer","author":"Hage J","year":"2007","journal-title":"Cochrane Database Syst. 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