Comparative analysis of the effectiveness of neoadjuvant systemic therapy and primary surgical treatment of patients with BRCA - associated triple-negative T1 breast cancer

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Abstract

BACKGROUND: BRCA-associated triple-negative breast cancer does not only have a better overall survival rate, but also a longer recurrence-free period in compatison to patients with sporadic breast cancer. BRCA-associated triple-negative breast cancer shows high sensitivity to chemotherapeutic agents, but the benefit of systemic neoadjuvant therapy for patients with tumor size ≤T1 in triple-negative breast cancer is unclear.

AIM: The aim of the study is to determine the recurrence rate in the patients with BRCA-associated triple-negative breast cancer and to determine the recurrence rate for the group of patients with tumor size ≤T1, depending on the initial treatment.

MATERIALS AND METHODS: The study includes the data of 129 patients diagnosed with BRCA-associated triple-negative breast cancer treated in the period from 2010 to 2022 at the Department of Breast Tumors of the N.N. Petrov National Medical Research Center of Oncology. All the patients have been divided into two groups depending on the initial treatment. Group I included 93 (72.1%) patients whose treatment was started with systemic neoadjuvant therapy, group II, whose initial treatment involved surgery, included 36 (27.9%) patients.

RESULTS: In group I, the number of recurrences was 22 (23.6%), and in group II — 6 (16.6%). Depending on the pathomorphological response to systemic neoadjuvant therapy, the patients of group I have been separated: in the group of patients with a complete pathomorphological response, the number of relapses was 6 (13.3%), and in the group of patients with a partial pathomorphological response — 16 (33.3%). A comparative analysis of 2 groups with tumor size ≤T1 has shown that in group I the number of patients with tumor size ≤T1 was 11 (11.8%) cases, and in group II — 16 (44.4%). Subgroup comparative analysis in group I, taking into account tumor size ≤T1, has shown that recurrence has not been observed when a complete pathomorphological response was achieved in 8 (17.7%) patients, and in the group with partial pathomorphological response in 3 (6.25%) patients with tumor size ≤T1. A relapse has been observed in 1 (2%) case. With clinical tumor size ≤T1 (n = 16), there was no recurrence in group II.

CONCLUSIONS: Patients diagnosed with BRCA-associated triple-negative breast cancer remain at a high risk of recurrence at a later stage of the disease, but this does not apply to patients with a tumor size ≤T1 since the difference in relapse-free survival [AP1] between patients, whose treatment was started with neoadjuvant systemic therapy and patients, whose initial treatment involved surgery % with a clinical tumor size ≤T1, is not confirmed.

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About the authors

Diana A. Enaldieva

N.N. Petrov National Medical Research Centre of Oncology

Author for correspondence.
Email: dianaenaldieva932@gmail.com
ORCID iD: 0000-0002-2773-3111
SPIN-code: 2372-3622

PhD student

Russian Federation, Saint Petersburg

Roman V. Donskikh

N.N. Petrov National Medical Research Centre of Oncology

Email: Rdonskih@rambler.ru
ORCID iD: 0000-0002-9391-5327
SPIN-code: 5111-8211

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Petr V. Krivorotko

N.N. Petrov National Medical Research Centre of Oncology

Email: dr.krivorotko@mail.ru
ORCID iD: 0000-0002-4898-9159
SPIN-code: 2448-7506
Scopus Author ID: 36600762900

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Evgeny N. Imyanitov

N.N. Petrov National Medical Research Centre of Oncology; Saint Petersburg State Pediatric State Medical University

Email: evgeny@imyanitov.spb.ru
ORCID iD: 0000-0003-4529-7891
SPIN-code: 1909-7323

MD, Dr. Sci. (Med.), Professor, Correspondence Member of the RAS

Russian Federation, Saint Petersburg; Saint Petersburg

Elena K. Zhiltsova

N.N. Petrov National Medical Research Centre of Oncology

Email: ziltsova@yandex.ru
ORCID iD: 0000-0002-2029-4582
SPIN-code: 3045-1704

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Anna P. Sokolenko

N.N. Petrov National Medical Research Centre of Oncology; Saint Petersburg State Pediatric State Medical University

Email: annasokolenko@mail.ru
ORCID iD: 0000-0001-6304-1609
SPIN-code: 1256-9758
Scopus Author ID: 7004209770

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg; Saint Petersburg

Tengiz T. Tabagua

N.N. Petrov National Medical Research Centre of Oncology

Email: tedo8308@mail.ru
ORCID iD: 0000-0003-1471-9473
SPIN-code: 4466-6316

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Nikolay S. Amirov

N.N. Petrov National Medical Research Centre of Oncology

Email: amirovn17@gmail.com
ORCID iD: 0000-0002-2421-3284
SPIN-code: 7793-4290

PhD student

Russian Federation, Saint Petersburg

Roman S. Pesotsky

N.N. Petrov National Medical Research Centre of Oncology

Email: shipmeback@gmail.com
ORCID iD: 0000-0002-2573-2211
Russian Federation, Saint Petersburg

Laysan F. Shaikhelislamova

N.N. Petrov National Medical Research Centre of Oncology

Email: leisyanka97@mail.ru
ORCID iD: 0000-0001-9623-3877
Russian Federation, Saint Petersburg

Alexander S. Emelyanov

N.N. Petrov National Medical Research Centre of Oncology

Email: ae28111992@yandex.ru
ORCID iD: 0000-0002-0528-9937
SPIN-code: 6312-4894
Russian Federation, Saint Petersburg

Viktoria V. Mortada

N.N. Petrov National Medical Research Centre of Oncology

Email: vika-gukova@mail.ru
ORCID iD: 0000-0002-1982-5710
SPIN-code: 3871-8774

PhD student

Russian Federation, Saint Petersburg

Larisa P. Gigolaeva

N.N. Petrov National Medical Research Centre of Oncology

Email: gigosha532@gmail.com
ORCID iD: 0000-0001-7654-4336
SPIN-code: 3521-7448

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Sergey S. Yerechshenko

N.N. Petrov National Medical Research Centre of Oncology

Email: dr.ereschenko@gmail.com
ORCID iD: 0000-0002-5090-7001
SPIN-code: 5957-9137

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Alexander V. Komyakhov

N.N. Petrov National Medical Research Centre of Oncology

Email: komyahov@yandex.ru
ORCID iD: 0000-0002-6598-1669
SPIN-code: 8286-4406

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Kirill S. Nikolaev

N.N. Petrov National Medical Research Centre of Oncology

Email: kirill.nikolaev87@gmail.com
ORCID iD: 0000-0003-3377-6369
SPIN-code: 5627-6696

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Konstantin Yu. Zernov

N.N. Petrov National Medical Research Centre of Oncology

Email: konstantin_zernov@hotmail.com
ORCID iD: 0000-0002-2138-3982
SPIN-code: 9186-5705

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Yana I. Bondarchuk

N.N. Petrov National Medical Research Centre of Oncology

Email: yana_bondarchuk_2015@mail.ru
ORCID iD: 0000-0002-6442-0106
SPIN-code: 9546-3222

PhD student

Russian Federation, Saint Petersburg

Ruslan M. Paltuev

N.N. Petrov National Medical Research Centre of Oncology

Email: paltuev@mail.ru
ORCID iD: 0000-0002-0871-9453
SPIN-code: 9963-3032
Scopus Author ID: 6505715557

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Alexander A. Bessonov

Leningrad Regional Clinical Oncology Center

Email: dr.bessonov@gmail.com
ORCID iD: 0000-0002-6649-7641
SPIN-code: 3553-4670

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Anna S. Artemyeva

N.N. Petrov National Medical Research Centre of Oncology

Email: oinochoya@gmail.com
ORCID iD: 0000-0002-2948-397X
SPIN-code: 5760-5463

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vladislav V. Semiglazov

N.N. Petrov National Medical Research Centre of Oncology; Pavlov First Saint Petersburg State Medical University

Email: oncology.spbgmu@mail.ru
ORCID iD: 0000-0002-8825-5221
SPIN-code: 6786-9577
Scopus Author ID: 7006310596

д-р мед. наук

Russian Federation, Saint Petersburg; Saint Petersburg

Tatiana Yu. Semiglazova

N.N. Petrov National Medical Research Centre of Oncology

Email: tsemiglazova@mail.ru
ORCID iD: 0000-0002-4305-6691
SPIN-code: 9773-3759
Scopus Author ID: 8562948700

MD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Vladimir F. Semiglazov

N.N. Petrov National Medical Research Centre of Oncology

Email: ssemiglazov@mail.ru
ORCID iD: 0000-0003-0077-9619
SPIN-code: 3874-9539
Scopus Author ID: 18838622600

MD, Dr. Sci. (Med.), Professor, Correspondence Member of the RAS

Russian Federation, Saint Petersburg

Alexsey M. Belyaev

N.N. Petrov National Medical Research Centre of Oncology; North-Western State Medical University named after I.I. Mechnikov

Email: bam281060@yandex.ru
ORCID iD: 0000-0001-5580-4821
SPIN-code: 9445-9473

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

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