{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:45:09Z","timestamp":1792071909429,"version":"4.4.0"},"reference-count":38,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[1999,2]]},"abstract":"<jats:p> PURPOSE: To assess patient and tumor characteristics associated with a complete pathologic response (pCR) in both the breast and axillary lymph node specimens and the outcome of patients found to have a pCR after neoadjuvant chemotherapy for locally advanced breast cancer (LABC). <\/jats:p><jats:p> PATIENTS AND METHODS: Three hundred seventy-two LABC patients received treatment in two prospective neoadjuvant trials using four cycles of doxorubicin-containing chemotherapy. Patients had a total mastectomy with axillary dissection or segmental mastectomy and axillary dissection followed by four or more cycles of additional chemotherapy. Patients then received irradiation treatment of the chest-wall or breast and regional lymphatics. Median follow-up was 58 months (range, 8 to 99 months). <\/jats:p><jats:p> RESULTS: The initial nodal status, age, and stage distribution of patients with a pCR were not significantly different from those of patients with less than a pCR (P\u2009&gt;\u2009.05). Patients with a pCR had initial tumors that were more likely to be estrogen receptor (ER)\u2013negative (P\u2009&lt;\u2009.01), and anaplastic (P\u2009=\u2009.01) but of smaller size (P\u2009&lt;\u2009.01) than those of patients with less than a pCR. Upon multivariate analysis, the effects of ER status and nuclear grade were independent of initial tumor size. Sixteen percent of the patients in this study (n\u2009=\u200960) had a pathologic complete primary tumor response. Twelve percent of patients (n\u2009=\u200943) had no microscopic evidence of invasive cancer in their breast and axillary specimens. A pathologic complete primary tumor response was predictive of a complete axillary lymph node response (P\u2009&lt;\u2009.01). The 5-year overall and disease-free survival rates were significantly higher in the group who had a pCR (89% and 87%, respectively) than in the group who had less than a pCR (64% and 58%, respectively; P\u2009&lt;\u2009.01). <\/jats:p><jats:p> CONCLUSION: Neoadjuvant chemotherapy has the capacity to completely clear the breast and axillary lymph nodes of invasive tumor before surgery. Patients with LABC who have a pCR in the breast and axillary nodes have a significantly improved disease-free survival rate. However, a pCR does not entirely eliminate recurrence. Further efforts should focus on elucidating the molecular mechanisms associated with this response. <\/jats:p>","DOI":"10.1200\/jco.1999.17.2.460","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T06:19:31Z","timestamp":1487917171000},"page":"460-460","source":"Crossref","is-referenced-by-count":1119,"title":["Clinical Course of Breast Cancer Patients With Complete Pathologic Primary Tumor and Axillary Lymph Node Response to Doxorubicin-Based Neoadjuvant Chemotherapy"],"prefix":"10.1200","volume":"17","author":[{"given":"Henry M.","family":"Kuerer","sequence":"first","affiliation":[{"name":"From the Departments of Surgical Oncology, Biomathematics, Breast Medical Oncology, Pathology, and Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Newman","sequence":"additional","affiliation":[{"name":"From the Departments of Surgical Oncology, 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Pathology, and Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil","family":"Dhingra","sequence":"additional","affiliation":[{"name":"From the Departments of Surgical Oncology, Biomathematics, Breast Medical Oncology, Pathology, and Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Theriault","sequence":"additional","affiliation":[{"name":"From the Departments of Surgical Oncology, Biomathematics, Breast Medical Oncology, Pathology, and Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"From the Departments of Surgical Oncology, Biomathematics, Breast Medical Oncology, Pathology, and Radiation 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