{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:03:55Z","timestamp":1788973435554,"version":"build-2803163510"},"reference-count":63,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: To evaluate the neoadjuvant chemotherapy (NACTx) process in breast cancer (BC), its significant treatment-related adverse events (trAEs), tumor clinical response rates, and surgical and pathological outcomes, and to analyze factors influencing cavity shaving and axillary lymph node dissection (ALND) following sentinel lymph node biopsy (SLNB). Methods: A comprehensive retrospective study was conducted at a single center on patients who received NACTx for BC between 2015 and 2021. Results: Medical records of 242 patients were reviewed. Approximately one-fifth encountered grade \u2265 3 trAEs (21.5%), leading 3.3% to discontinue chemotherapy. Anthracycline cardiotoxicity (2.2%) caused one death (mortality rate = 0.4%). For clinical response and surgical and pathological outcomes, 229 patients were eligible. Clinical progression occurred in 3.9% of the patients (14% in triple-negative BC, p = 0.004). Breast-conserving surgery (BCS) was performed in 55% of the patients. There was no significant difference between the type of breast surgery (BCS vs. mastectomy) and molecular subtype, histology, tumor size, or tumor\u2019s pathological response degree. Cavity shaving was required in one-fifth of the patients who underwent BCS (n = 134) due to an invasive tumor at the surgical margin (SM). Tumor histology (invasive ductal vs. invasive lobular carcinoma; OR: 4.962, 95% CI 1.007\u201324.441, p = 0.049) and tumor SUVMax value (OR: 0.866, 95% CI 0.755\u20130.993, p = 0.039) had significant independent efficacy on SM positivity. Initially, 75% underwent SLNB, but nearly half of them needed ALND. ALND rates were significantly higher in the luminal A and LB-HER2(\u2212) groups (87% vs. 69%) than in the HER2(+) and TN groups (43% to 50%) (p = 0.001). All luminal A patients and those with lobular histology required ALND after SLNB, but no patients in the HER2-enriched group required ALND. ER positivity and higher PR expression levels were associated with an increased need for ALND after SLNB, whereas HER2 positivity and higher SUVMax values of LN(s) were associated with a significantly reduced need for ALND. About 27% of the patients achieved overall pCR. No pCR was achieved in the LA group. Conclusions: The BC NACTx process requires close monitoring due to severe AEs and disease progression. NACTx decisions must be made on experienced multidisciplinary tumor boards, considering tumor characteristics and expected targets.<\/jats:p>","DOI":"10.3390\/cancers17020163","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T05:06:34Z","timestamp":1736226394000},"page":"163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Comprehensive Analysis of Neoadjuvant Chemotherapy in Breast Cancer: Adverse Events, Clinical Response Rates, and Surgical and Pathological Outcomes\u2014Bozyaka Experience"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7861-5000","authenticated-orcid":false,"given":"Cengiz","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Medical Oncology, Izmir City Hospital, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1812-6846","authenticated-orcid":false,"given":"Baha","family":"Zengel","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"General Surgery Clinic, MedicalPoint International Hospital, Izmir University of Economics, 35575 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"\u00dcreyen","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of General Surgery, Izmir Faculty of Medicine, University of Health Sciences Turkey, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra Hilal","family":"Ad\u0131belli","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Radiology, Izmir Faculty of Medicine, University of Health Sciences Turkey, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funda","family":"Ta\u015fl\u0131","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Pathology, Izmir Faculty of Medicine, University of Health Sciences Turkey, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan Taylan","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Onkomer Private Oncology Radiotherapy Center, 35100 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zlem","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Medical Oncology, Izmir City Hospital, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demet","family":"Kocatepe \u00c7avdar","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Pathology, Izmir City Hospital, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fclya","family":"Mollamehmeto\u011flu","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"LaMED View Central, 35220 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3274-2565","authenticated-orcid":false,"given":"Umut","family":"\u00c7ak\u0131ro\u011flu","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of Medical Oncology, Izmir City Hospital, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u015far","family":"\u0130mren","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Nuclear Medicine Clinic, Cigli Regional Education Hospital, Bak\u0131rcay University, 35620 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sava\u015f","family":"Yakan","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of General Surgery, Izmir Faculty of Medicine, University of Health Sciences Turkey, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enver","family":"\u0130lhan","sequence":"additional","affiliation":[{"name":"Bozyaka Education and Research Hospital, University of Health Sciences Turkey, 35170 Izmir, Turkey"},{"name":"Department of General Surgery, Izmir Faculty of Medicine, University of Health Sciences Turkey, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"L\u00f8yland, B., Sandbekken, I.H., Grov, E.K., and Utne, I. (2024). Causes and Risk Factors of Breast Cancer, What Do We Know for Sure?An Evidence Synthesis of Systematic Reviews and Meta-Analyses. Cancers, 16.","DOI":"10.3390\/cancers16081583"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1200\/GO.20.00033","article-title":"Overview of Breast Cancer and Implications of Overtreatment of Early-Stage Breast Cancer: An Indian Perspective","volume":"6","author":"Bhattacharyya","year":"2020","journal-title":"JCO Glob. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Derouane, F., Van Marcke, C., Berli\u00e8re, M., Gerday, A., Fellah, L., Leconte, I., Van Bockstal, M.R., Galant, C., Corbet, C., and Duhoux, F.P. (2022). Predictive Biomarkers of Response to Neoadjuvant Chemotherapy in Breast Cancer: Current and Future Perspectives for Precision Medicine. Cancers, 14.","DOI":"10.3390\/cancers14163876"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1245\/s10434-010-1008-1","article-title":"The Relevance of Breast Cancer Subtypes in the Outcome of Neoadjuvant Chemotherapy","volume":"17","author":"Straver","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1245\/s10434-018-6531-5","article-title":"Neoadjuvant Chemotherapy Use in Breast Cancer Is Greatest in Excellent Responders: Triple-Negative and HER2+ Subtypes","volume":"25","author":"Murphy","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00280-014-2542-5","article-title":"Clinicopathological Features of Early Failure of Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer","volume":"74","author":"Choi","year":"2014","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.clbc.2016.06.010","article-title":"Anthracycline-Free Neoadjuvant Chemotherapy Ensures Higher Rates of Pathologic Complete Response in Breast Cancer","volume":"17","author":"Salerno","year":"2017","journal-title":"Clin. Breast Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1200\/JCO.2009.25.3286","article-title":"Predictors of Tumor Progression During Neoadjuvant Chemotherapy in Breast Cancer","volume":"28","author":"Caudle","year":"2010","journal-title":"JCO"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1245\/s10434-010-1390-8","article-title":"Impact of Progression During Neoadjuvant Chemotherapy on Surgical Management of Breast Cancer","volume":"18","author":"Caudle","year":"2011","journal-title":"Ann. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8703","DOI":"10.3390\/curroncol30100630","article-title":"The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review","volume":"30","author":"Ferrarazzo","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00268-020-05383-8","article-title":"The Impact of Neoadjuvant Chemotherapy on Margin Re-Excision in Breast-Conserving Surgery","volume":"44","author":"Devane","year":"2020","journal-title":"World J. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1002\/cncr.11603","article-title":"Neoadjuvant Chemotherapy for Breast Carcinoma: Multidisciplinary Considerations of Benefits and Risks","volume":"98","author":"Buchholz","year":"2003","journal-title":"Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.clon.2017.06.003","article-title":"Neoadjuvant Therapy in Early Breast Cancer: Treatment Considerations and Common Debates in Practice","volume":"29","author":"Cain","year":"2017","journal-title":"Clin. Oncol. R Coll Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"v8","DOI":"10.1093\/annonc\/mdv298","article-title":"Primary Breast Cancer: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up","volume":"26","author":"Senkus","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_15","first-page":"562","article-title":"Impact of Immunohistochemistry-Based Molecular Subtype on Chemosensitivity and Survival in Hispanic Breast Cancer Patients Following Neoadjuvant Chemotherapy","volume":"9","author":"Ossa","year":"2015","journal-title":"Ecancermedicalscience"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"412","DOI":"10.5306\/wjco.v5.i3.412","article-title":"Biological Subtypes of Breast Cancer: Prognostic and Therapeutic Implications","volume":"5","author":"Yersal","year":"2014","journal-title":"World J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1093\/annonc\/mdt303","article-title":"Personalizing the Treatment of Women with Early Breast Cancer: Highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013","volume":"24","author":"Goldhirsch","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1080\/15384047.2020.1756707","article-title":"The Treatment Option of Progressive Disease in Breast Cancer during Neoadjuvant Chemotherapy: A Single-Center Experience","volume":"21","author":"Zheng","year":"2020","journal-title":"Cancer Biol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3735","DOI":"10.21873\/anticanres.15863","article-title":"Impact of Tumor Progression on Survival During Neoadjuvant Chemotherapy in Breast Cancer: A Cohort Study","volume":"42","author":"Nozawa","year":"2022","journal-title":"Anticancer. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"626","DOI":"10.3348\/kjr.2022.0974","article-title":"Prediction of Tumor Progression During Neoadjuvant Chemotherapy and Survival Outcome in Patients With Triple-Negative Breast Cancer","volume":"24","author":"Yoen","year":"2023","journal-title":"Korean J. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1016\/S1470-2045(18)30570-9","article-title":"Neoadjuvant Chemotherapy with or without Anthracyclines in the Presence of Dual HER2 Blockade for HER2-Positive Breast Cancer (TRAIN-2): A Multicentre, Open-Label, Randomised, Phase 3 Trial","volume":"19","author":"Mandjes","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1159\/000452079","article-title":"Neoadjuvant Chemotherapy with Docetaxel, Carboplatin and Weekly Trastuzumab Is Active in HER2-Positive Early Breast Cancer: Results after a Median Follow-Up of over 4 Years","volume":"11","author":"Kolberg","year":"2016","journal-title":"Breast Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"200","DOI":"10.21037\/atm-22-4030","article-title":"Neoadjuvant Therapy with vs. without Anthracyclines for HER2-Positive Breast Cancer: A Systematic Review and Meta-Analysis","volume":"11","author":"Zhu","year":"2023","journal-title":"Ann. Transl. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/S0140-6736(23)00285-4","article-title":"Anthracycline-Containing and Taxane-Containing Chemotherapy for Early-Stage Operable Breast Cancer: A Patient-Level Meta-Analysis of 100 000 Women from 86 Randomised Trials","volume":"401","author":"Braybrooke","year":"2023","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"499","DOI":"10.18433\/jpps31862","article-title":"Analysis of Secondary Leukemia and Myelodysplastic Syndrome After Chemotherapy for Solid Organ Tumors Using the Food and Drug Administration Adverse Event Reporting System (FAERS)","volume":"24","author":"Kawashiri","year":"2021","journal-title":"J. Pharm. Pharm. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10549-016-4051-1","article-title":"Risk of Acute Myeloid Leukemia and Myelodysplastic Syndrome among Older Women Receiving Anthracycline-Based Adjuvant Chemotherapy for Breast Cancer on Modern Cooperative Group Trials (Alliance A151511)","volume":"161","author":"Freedman","year":"2017","journal-title":"Breast Cancer Res. Treat"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1200\/JCO.20.03399","article-title":"Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline","volume":"39","author":"Korde","year":"2021","journal-title":"JCO"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ejphar.2013.02.057","article-title":"Current Approaches for Neoadjuvant Chemotherapy in Breast Cancer","volume":"717","author":"Connolly","year":"2013","journal-title":"Eur. J. Pharmacol."},{"key":"ref_29","first-page":"e18194","article-title":"Association of Cardiotoxicity With Doxorubicin and Trastuzumab: A Double-Edged Sword in Chemotherapy","volume":"13","author":"Gabani","year":"2021","journal-title":"Cureus"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3754","DOI":"10.1161\/CIRCULATIONAHA.105.576850","article-title":"NAD(P)H Oxidase and Multidrug Resistance Protein Genetic Polymorphisms Are Associated With Doxorubicin-Induced Cardiotoxicity","volume":"112","author":"Wojnowski","year":"2005","journal-title":"Circulation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/j.amjcard.2013.08.026","article-title":"Review and Meta-Analysis of Incidence and Clinical Predictors of Anthracycline Cardiotoxicity","volume":"112","author":"Lotrionte","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1002\/ijc.33830","article-title":"Neoadjuvant Docetaxel plus Carboplatin vs. Epirubicin plus Cyclophosphamide Followed by Docetaxel in triple-negative, early-stage Breast Cancer (NeoCART): Results from a Multicenter, Randomized Controlled, open-label Phase II Trial","volume":"150","author":"Zhang","year":"2022","journal-title":"Int. J. Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.clbc.2020.09.007","article-title":"Response and Prognosis of Docetaxel and Cyclophosphamide as Neoadjuvant Chemotherapy in ER+ HER2\u2212 Breast Cancer: A Prospective Phase II Study","volume":"20","author":"Hayashi","year":"2020","journal-title":"Clin. Breast Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s12282-016-0666-7","article-title":"Docetaxel and Cyclophosphamide as Neoadjuvant Chemotherapy in HER2-Negative Primary Breast Cancer","volume":"24","author":"Nakatsukasa","year":"2017","journal-title":"Breast Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1093\/annonc\/mdt182","article-title":"Pertuzumab plus Trastuzumab in Combination with Standard Neoadjuvant Anthracycline-Containing and Anthracycline-Free Chemotherapy Regimens in Patients with HER2-Positive Early Breast Cancer: A Randomized Phase II Cardiac Safety Study (TRYPHAENA)","volume":"24","author":"Schneeweiss","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.breast.2011.12.012","article-title":"Epirubicin: Is It like Doxorubicin in Breast Cancer? A Clinical Review","volume":"21","author":"Khasraw","year":"2012","journal-title":"Breast"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.amjsurg.2020.11.053","article-title":"Neoadjuvant Chemotherapy for Luminal a Breast Cancer: Factors Predictive of Histopathologic Response and Oncologic Outcome","volume":"222","author":"Collins","year":"2021","journal-title":"Am. J. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e210891","DOI":"10.1001\/jamasurg.2021.0891","article-title":"Axillary Pathologic Complete Response After Neoadjuvant Systemic Therapy by Breast Cancer Subtype in Patients With Initially Clinically Node-Positive Disease: A Systematic Review and Meta-Analysis","volume":"156","author":"Samiei","year":"2021","journal-title":"JAMA Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1159\/000489785","article-title":"Predictors of Pathological Complete Response in Women with Clinical Complete Response to Neoadjuvant Chemotherapy in Breast Carcinoma","volume":"95","author":"Resende","year":"2018","journal-title":"Oncology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1111\/tbj.13763","article-title":"Predictive Factors for Omitting Lymphadenectomy in Patients with Node-positive Breast Cancer Treated with Neo-adjuvant Systemic Therapy","volume":"26","author":"Falo","year":"2020","journal-title":"Breast J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.ejso.2019.01.219","article-title":"Sentinel Node Biopsy after Primary Systemic Therapy in Node Positive Breast Cancer Patients: Time Trend, Imaging Staging Power and Nodal Downstaging According to Molecular Subtype","volume":"45","author":"Zuber","year":"2019","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.suronc.2018.02.003","article-title":"Risk Scoring System for Predicting Axillary Response after Neoadjuvant Chemotherapy in Initially Node-Positive Women with Breast Cancer","volume":"27","author":"Ouldamer","year":"2018","journal-title":"Surg. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/tbj.13206","article-title":"Breast Cancer Subtypes Affect the Nodal Response after Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer: Are We Ready to Endorse Axillary Conservation?","volume":"25","author":"Cerbelli","year":"2019","journal-title":"Breast J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1001\/jama.2011.90","article-title":"Axillary Dissection vs. No Axillary Dissection in Women With Invasive Breast Cancer and Sentinel Node Metastasis: A Randomized Clinical Trial","volume":"305","author":"Giuliano","year":"2011","journal-title":"JAMA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2856","DOI":"10.1002\/cncr.25120","article-title":"Trastuzumab-Based Neoadjuvant Therapy in Patients with HER2-Positive Breast Cancer","volume":"116","author":"Chang","year":"2010","journal-title":"Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1470-2045(11)70336-9","article-title":"Efficacy and Safety of Neoadjuvant Pertuzumab and Trastuzumab in Women with Locally Advanced, Inflammatory, or Early HER2-Positive Breast Cancer (NeoSphere): A Randomised Multicentre, Open-Label, Phase 2 Trial","volume":"13","author":"Gianni","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101965","DOI":"10.1016\/j.ctrv.2020.101965","article-title":"HER2-Enriched Subtype and Pathological Complete Response in HER2-Positive Breast Cancer: A Systematic Review and Meta-Analysis","volume":"84","author":"Schettini","year":"2020","journal-title":"Cancer Treat. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/annonc\/mdy127","article-title":"Platinum-Based Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis","volume":"29","author":"Poggio","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1158\/1078-0432.CCR-06-1109","article-title":"The Triple Negative Paradox: Primary Tumor Chemosensitivity of Breast Cancer Subtypes","volume":"13","author":"Carey","year":"2007","journal-title":"Clin. Cancer Res."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Lehmann, B.D., Jovanovi\u0107, B., Chen, X., Estrada, M.V., Johnson, K.N., Shyr, Y., Moses, H.L., Sanders, M.E., and Pietenpol, J.A. (2016). Refinement of Triple-Negative Breast Cancer Molecular Subtypes: Implications for Neoadjuvant Chemotherapy Selection. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157368"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-017-4598-5","article-title":"Breast-Conserving Surgery Following Neoadjuvant Therapy-a Systematic Review on Surgical Outcomes","volume":"168","author":"Volders","year":"2018","journal-title":"Breast Cancer Res Treat"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa1504473","article-title":"A Randomized, Controlled Trial of Cavity Shave Margins in Breast Cancer","volume":"373","author":"Chagpar","year":"2015","journal-title":"N Engl. J. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.suronc.2020.11.003","article-title":"Do We Need to Routinely Perform Cavity Shaving with Breast-Conserving Surgery for Breast Cancer? A Systematic Review and Meta-Analysis","volume":"36","author":"Mohamedahmed","year":"2021","journal-title":"Surg. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Tinterri, C., Barbieri, E., Sagona, A., Di Maria Grimaldi, S., and Gentile, D. (2024). De-Escalation of Axillary Surgery in Clinically Node-Positive Breast Cancer Patients Treated with Neoadjuvant Therapy: Comparative Long-Term Outcomes of Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection. Cancers, 16.","DOI":"10.3390\/cancers16183168"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S0140-6736(13)62422-8","article-title":"Pathological Complete Response and Long-Term Clinical Benefit in Breast Cancer: The CTNeoBC Pooled Analysis","volume":"384","author":"Cortazar","year":"2014","journal-title":"Lancet"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1200\/JCO.2011.38.8595","article-title":"Definition and Impact of Pathologic Complete Response on Prognosis after Neoadjuvant Chemotherapy in Various Intrinsic Breast Cancer Subtypes","volume":"30","author":"Untch","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1200\/JCO.2007.15.0235","article-title":"Preoperative Chemotherapy: Updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27","volume":"26","author":"Rastogi","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_58","first-page":"CD014805","article-title":"Platinum-Based Chemotherapy for Early Triple-Negative Breast Cancer","volume":"9","author":"Mason","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1056\/NEJMoa1910549","article-title":"Pembrolizumab for Early Triple-Negative Breast Cancer","volume":"382","author":"Schmid","year":"2020","journal-title":"N Engl. J. Med."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Holanek, M., Selingerova, I., Bilek, O., Kazda, T., Fabian, P., Foretova, L., Zvarikova, M., Obermannova, R., Kolouskova, I., and Coufal, O. (2021). Neoadjuvant Chemotherapy of Triple-Negative Breast Cancer: Evaluation of Early Clinical Response, Pathological Complete Response Rates, and Addition of Platinum Salts Benefit Based on Real-World Evidence. Cancers, 13.","DOI":"10.3390\/cancers13071586"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1056\/NEJMoa1612645","article-title":"Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy","volume":"376","author":"Masuda","year":"2017","journal-title":"N Engl. J. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMoa1814017","article-title":"Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer","volume":"380","author":"Huang","year":"2019","journal-title":"N Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1186\/s40064-016-2351-x","article-title":"Toxicities of Docetaxel: Original Drug versus Generics\u2014A Comparative Study about 81 Cases","volume":"5","author":"Tanz","year":"2016","journal-title":"SpringerPlus"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/2\/163\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:24:11Z","timestamp":1759919051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/2\/163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":63,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["cancers17020163"],"URL":"https:\/\/doi.org\/10.3390\/cancers17020163","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]}}}