Triple Negatif ve Her2 Pozitif Adjuvan veya Neoadjuvan Kemoterapi Alan Meme Kanseri Hastalarının Klinikopatolojik Özelliklerin Değerlendirilmesi

Abstract

Ayar Y. Evaluatıon of clınıco-pathological features of patıents wıth trıple negatıve and her2 posıtıve breast cancer treated wıth adjuvant or neoadjuvant chemotheraphy. Hacettepe University Faculty of Medicine, Internal Diseases Specialty Thesis, ANKARA, 2021 Aim: Breast cancer is the most frequently seen malignancy in women. Clinical and pathological features of patients have an effect on both the course and survival. Neoadjuvant therapy used for the treatment of triple negative and Her2 positive breast cancer is recently increasing. In current study, it is aimed to evaluate the clinical and pathological features of patients with Her2 positive and triple negative breast cancer and to investigate the relationship of those parameters with survival. Methods: A total of 364 patients diagnosed and treated with breast cancer in Hacettepe University Medical Faculty Oncology Department between date of 2000 to 2020 (203 triple negative – 161 Her2 positive/ 250 adjuvant – 114 neoadjuvant) included into the study. Demographic features (age, age at the diagnosis, menopause status), chemotheraphy protocols, pathological data (pathological response status, ER/PR status, HER 2 status), hematologic and biochemistry data of patients were retropspectively gathered. Survival analyzes was achieved by using Kaplan Meier graphics and a Log-rank test was used while comparing the survival duration among prognostic subgroups. Results: Patients were separated both adjuvant and neoadjuvant chemotheraphy groups and according to molecular subgroups. Both composite survival and disease free survival were higher in group whom were Her2 positive and adjuvantly treated than in group with triple negative (p=0.027). Disease free survival was longer in patients whom a complete pathologic response (cPR) revealed (p=0.025). We evaluated parameters of NLR (Neutrophil/Lymphocyte Ratio) – PLR (Platelet / Lmyphocyte Ratio) – AGR (Albumin/Globulin Ratio) regarding their prognostic importance and their relationship with survival. We did not detected significant relevance of the three parameters with survival. Both composite survival and disease free survival was worse in patients with high LDH levels. Conclusion: In studies, some inflammatuary parameters like NLR – PLR – AGR – LDH have been found to play roles in chemotheraphy response and to have prognostic importance for survival. Only LDH was detected to be significantly related in our study. More researchs with respect to parameters predicting the response to theraphy and affecting survival in breast cancer are needed.