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Year : 2017  |  Volume : 30  |  Issue : 4  |  Page : 1168-1177

Predictive significance of stromal-associated lymphocytes in response to neoadjuvant chemotherapy in breast cancer

1 Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Department of Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
3 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Afaf T Ibrahiem
Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_522_17

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Objective In this work, we aimed to assess whether the high stromal-associated lymphocytes and their subtypes in pretreatment core biopsies from patients with invasive breast carcinoma have a predictive role in pathologic response to neoadjuvant chemotherapy (NACT). Background Tumor-infiltrating lymphocytes including stromal-associated lymphocytes in breast cancer are considered a form of the host immune response to malignancy. Several studies suggested that tumor-infiltrating lymphocytes could predict better response to NACT, but their roles in predicting complete pathologic response (pCR) rate after NACT still needs further evaluation. Patients and methods Stromal-associated lymphocytes were evaluated in 100 pretreatment core biopsies from primary breast cancer patients eligible for NACT. Cases were defined as lymphocyte-rich if the percentage of lymphocytes was more than 50% and also the lymphocytes were evaluated for CD20, CD3, CD8, and CD4. Type of pathological response to NACT was determined in post-therapy surgical specimens of the same patients, and we correlated between type of response to stromal-associated lymphocytes and their subtypes. Results pCR was detected in 22 (22%) breast cancer patients, partial pathologic response in 54 (54%), and no pathologic response in 24 (24%) patients. There was a significant association between percentage of stromal-associated lymphocytes and achievement of pCR rate (P = 0.006). In addition, high stromal-associated lymphocytes are significantly associated with advanced histological grade (P = 0.004), Ki-67 (P = 0.028), and negative estrogen receptor state (P = 0.015). Conclusion High stromal-associated lymphocytes and high percentage of CD8-positive T cells in stromal-associated lymphocytes could be reliable predictors for pCR rate after NACT.

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