Effect of tumor-infiltrating immune cells (mast cells, neutrophils and lymphocytes) on neoadjuvant chemotherapy response in breast carcinomas.

INTRODUCTION: Despite screening, the incidence of breast cancer is increasing worldwide. Neoadjuvant chemotherapy (NAC) response is one of the most important parameters taken into consideration in surgery, optimal adjuvant chemotherapy planning and prognosis prediction. Research on predictive markers for the response to NAC is still ongoing. In our study, we investigated the relationship between tumor-infiltrating neutrophils/mast cells/lymphocytes and NAC response in breast carcinomas. MATERIAL AND METHOD: Study included 117 patients who were diagnosed with invasive breast carcinoma using core needle biopsy. In these biopsies tumor-infiltrating neutrophils/mast cells/lymphocytes were evaluated and Miller Payne Score was used for NAC response. RESULT: 53 patients exhibited high TILs, 36 had high TINs, and 46 showed high TIMs. While pathological complete response was 27 % in all patients, it was 38 % in high TINs patients, 35 % in high TILs patients, and 28 % in high TIMs patients. High TIMs were observed to be statistically associated with survival. TILs, TINs, nuclear grade, ER, PR and HER2 expression, Ki-67 proliferation index were found to be associated with the Miller - Payne score. In multivariate analysis, TINs, nuclear grade, pathological stage, and molecular subtype were found to be independent risk factors for treatment response. CONCLUSION: TINs have better prognostic value to predict neoadjuvant treatment than TILs. High TIMs are associated with increased overall survival. The inclusion of TINs in NAC response and TIMs in overall survival in pathology reports and treatment planning is promising in breast carcinomas as they are simple to use and reproducible markers.

Treatment of massive liver metastasis of breast cancer during pregnancy: first report of a complete remission with trastuzumab and review of literature.

Background: Metastatic breast cancer diagnosis is the most common malignancy in pregnancy and the incidence of it has been increasing among the pregnant women due to advancing maternal age within the populations. However, there are limited data about the use of trastuzumab during pregnancy with conflicting results.Case history: A 37-year-old pregnant female patient was admitted to our hospital with the metastatic breast cancer diagnosis. An MRI study showed metastatic solid masses in all lobes and segments of the patient's liver. Patient was treated with weekly docetaxel and trastuzumab regimen from 22 to 34 weeks and labored electively at the 35th gestational week. Antenatal follow-up of the fetus showed all normal ranges without any complications. An abdominal MRI following the labor revealed complete clearance of liver metastasis.Conclusions: Use of trastuzumab during pregnancy is debated due to the limited number of cases reported in the literature. This article gives a summary of the existing data where the outcome was a complete remission in disease with normal fetal development during pregnancy.