Evaluation of the results of neoadjuvant treatment in patients with HER2 positive breast cancer subtype

Abstract

Background. In women, breast cancer is the most common malignant tumor. Based on current clinical guidelines for HER2 positive tumor growth, it is possible to carry out preoperative chemotherapy for further organ-preserving operations. However, a prognostic scale for assessing neoadjuvant treatment has not yet been developed.

Aim. To create a mathematical model on the basis of which a computer program was developed to determine the likelihood of the neoadjuvant treatment effectiveness in patients diagnosed with HER2 positive breast cancer for further organ-preserving operations.

Material and methods. A planned retrospective study was performed at the Samara Regional Clinical Oncology Dispensary to assess the results of combined treatment of 93 patients diagnosed with breast cancer with HER2-positive tumor growth subtype with organ-preserving operations. The age of the patients was from 31 to 62 years, the mean age was 47.11±9.78 years. Three (15.53%) patients were diagnosed with stage I of the disease according to the TNM system, and 90 (84.47%) — with stage II. A search for statistically significant predictors of achieving morphological regression as a result of preoperative chemotherapy was carried out.

Results. The mathematical model was created in the logistic regression module according to Wald's algorithm. Using SPSS 10.0, stepwise exclusion of predictors was performed. As a result of the multivariate analysis, a mathematical model and the corresponding program for the electronic computer “Calculation of the achievement of complete morphological regression in patients diagnosed with primary operable breast cancer with epidermal growth factor receptors” after neoadjuvant chemotherapy were created. In the future, the evaluation of the effectiveness of this program was compared with the results of 206 patients’ treatment.

Conclusion. The creation of a mathematical model and a computer program made it possible to personalize the most effective treatment regimen for patients diagnosed with HER2 positive breast cancer, depending on the initial characteristics of the tumor.

Keywords

breast cancer / neoadjuvant chemotherapy / HER2 positive subtype / organ-preserving operations / mathematical model / morphological regression / computer program

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