Factors predicting treatment responsiveness and prognosis in node-negative breast cancer

A. M. Neville, R. Bettelheim, R. D. Gelber, J. Säve-Söderberght, B. W. Davis, R. Reed, J. Torhorst, R. Golouh, H. F. Peterson, K. N. Price, M. Isley, C. M. Rudenstam, J. Collins, M. Castiglione, H. J. Senn, A. Goldhirsch

Research output: Contribution to journalArticlepeer-review


Purpose: An international trial (formerly Ludwig Trial V) has been conducted in 1,275 subjects to ascertain if perioperative chemotherapy is beneficial for nodenegative breast cancer patients and to identify subgroups of patients who benefit from this therapy. Patients and Methods: Node-negative breast cancer patients were randomized to receive either one cycle of perioperative chemotherapy or no adjuvant treatment. A detailed pathology review was conducted in 1,203 of the 1,275 patients enrolled. Stepwise Cox regression analysis was used to search for factors either predicting chemotherapeutic responsiveness and/or influencing disease-free survival (DFS). Results: As expected, primary tumor size, grade, and the presence of peritumoral vascular invasion are the most important prognostic factors. Perioperative chemotherapy provides a DFS advantage at 5 years of median follow-up and such treatment is more effective for estrogen receptor-negative than for estrogen receptor-positive tumors, for histologic grade 2 and 3 than for grade 1 tumors, and for patients in whom no axillary lymph node metastases were found even after serial sectioning and review by the Central Pathology Laboratory. Conclusion: Hormone receptor status and tumor grade are important factors for predicting responsiveness to perioperative chemotherapy in node-negative breast cancer.

Original languageEnglish
Pages (from-to)696-705
Number of pages10
JournalJournal of Clinical Oncology
Issue number5
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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