The influence factors of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy

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Methods 290 female patients with breast cancer who treated with neoadjuvant chemotherapy were enrolled in this study. The collected data including tumor position, tumor size, cTNM staging, LNR, pathological molecular types(including ER, PR, Her-2, Ki-67 and so on), neoadjuvant chemotherapy regimens, pathological complete response rate, postoperative treatment and survival time. Results Neoadjuvant chemotherapy curative effect was related to pausimenia, T staging, N staging, ER/PR and Ki-67(P < 0.05), N staging (OR = 0.041, 95% CI = 0.012 ~ 0.134) and Ki-67 (OR = 9.340, 95% CI = 1.770 ~ 49.286) were independent risk factors of pCR. Recurrence of metastases was related to T staging, LNR, Ki-67, ET regimen, postoperative chemotherapy and postoperation radiotherapy(P < 0.05), T staging (OR = 1.731, 95%CI = 1.244 ~ 2.408), LNR (OR = 2.726, 95%CI = 1.430 ~ 5.197) and Ki-67 (OR = 3.107, 95%CI = 1.395 ~ 6.920) were independent risk factors of recurrence of metastases. Patients with low Ki-67 expression, low LNR, T1 staging and T2 staging and N0/N1/N2 staging had a better prognosis. Conclusion Clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy were related to cTNM staging, LNR, ER/PR and Ki-67. Breast cancer Neoadjuvant chemotherapy Pathological complete response Prognosis Figures Figure 1 Figure 2 Figure 3 1. Introduction Breast cancer is the most common malignancy in women, which is a serious threat to women's life quality and health. According to a statistic from the American Cancer Society [ 1 ], breast cancer ranks first in the incidence of new malignant tumors in women, with an annual increase of about 0.3% in the past five years, and the incidence is the highest among white people. China is also a country with a high incidence of breast cancer. According to the statistics of China Cancer Center in 2018 [ 2 ], the cases and deaths of female breast cancer accounted for 11.2% and 9.2% of the global incidence and mortality respectively, ranking among the highest in the world. With the gradual improvement of the level of breast cancer screening and early screening, early breast cancer has been found and treated in time, but there are still a lot of patients with local advanced breast cancer, which is still a very prominent clinical problem worldwide [ 3 ]. Neoadjuvant chemotherapy is a standard treatment for locally advanced breast cancer. It has the advantages of inhibiting systemic micrometastasis, reducing tumor size, reducing tumor staging, improving surgical methods and evaluating tumor sensitivity to chemotherapy[ 4 , 5 ]. At present, the pCR rate of neoadjuvant chemotherapy for breast cancer patients is not ideal [ 6 , 7 ]. There are great differences in prognosis and response of different patients after chemotherapy. At present, there is no consensus on the predictors of neoadjuvant chemotherapy efficacy. Studies have found that the efficacy of neoadjuvant chemotherapy may be related to a variety of clinical and pathological indicators [ 8 – 10 ], such as tumor size, lymph node metastasis,tumor infiltrating lymphocytes and pathological molecular subtypes. In addition, it is generally believed that pathological complete remission after neoadjuvant chemotherapy is closely related to the disease-free survival and overall survival of breast cancer patients. Patients with complete pathological remission often have a better prognosis [ 11 , 12 ]. However, some studies [ 13 ] have shown that neoadjuvant chemotherapy has no correlation with prognosis and even has adverse effects. This may be because there are many factors affecting prognosis, such as BMI[ 14 ], TNM stage [ 15 ], tumor markers [ 16 ], pathological molecular types [ 17 ], etc. In addition, some studies have found that the lymph node ratio (LNR) is an independent risk factor for prognosis of breast cancer patients, and is more valuable than N stage [ 18 , 19 ]. This study investigated and followed up 290 female breast cancer patients in our hospital with neoadjuvant chemotherapy efficacy and prognosis, and analyzed the relationship with clinical characteristics, pathological indicators and treatment plan of the patients. 2. Materials And Methods 2.1 Case selection A retrospective study was conducted on female breast cancer patients who received neoadjuvant chemotherapy from December 2012 to December 2017 in Zhejiang Cancer Hospital. The criteria were as follows: ① breast cancer was diagnosed by pathological diagnosis. ② It has relatively complete clinical and pathological data. Exclusion criteria: ① serious lack of follow-up data; ② communication barriers; (3) bilateral breast cancer patients; ④ combined with other malignant tumors or major diseases affecting the dysfunction of important organs. After screening, a total of 290 women with breast cancer were enrolled in this study. The youngest was 14 years old, the oldest was 74 years old, with an average age of (48.4 ± 8.7) years. 2.2 Molecular typing criteria Immunohistochemical method was used to determine the molecular typing. The molecular typing standard was according to the 2013 St. Gallen Guide [ 20 ]:Luminal type A was ER positive and / or PR positive, HER-2 negative, Ki-67 < 14%;Luminal B1 was ER positive and / or PR positive, HER-2 negative, Ki-67 ≥ 14%;Luminal B2 was ER positive and / or PR positive, HER-2 positive and Ki-67 at any level;HER-2 overexpression type (HER-2 positive type): ER and PR deletion, HER-2 overexpression; Triple negative: ER and PR deletion, HER-2 negative. 2.3 Neoadjuvant chemotherapy scheme and efficacy judgment Patients and their families were informed of their detailed condition, treatment plan, chemotherapy risks and precautions, and preoperative neoadjuvant chemotherapy was performed after signing the chemotherapy consent form. Neoadjuvant chemotherapy regimen mainly include ET regimen (Epirubicin and Taxotere regimen, 34.5%), TC regimen (Taxotere and Cyclophosphamide regimen, 10.3%), AC or EC regimen (Adriamycin/Epirubicin and Cyclophosphamide, 9.7%), FEC regimen(Fluorouracil, Epirubicin and Cyclophosphamide regimen, 6.6%). If HER-2 is overexpressed, it will be combined with targeted therapy, mainly EC * 4 followed byTH (Taxotere and Herceptin) * 4 or TCH (Taxotere, Cyclophosphamide and Herceptin) * 6. Breast MRI was evaluated before and every 2 cycles of neoadjuvant chemotherapy to determine whether to change chemotherapy regimen and cycle. Pathological complete remission (pCR) criteria: there were no residual invasive cancer cells or only residual cancer components in situ in postoperative breast tissue, and lymph node metastatic lesions disappeared completely. The study was approved by Zhejiang Cancer Hospital, and all participants signed informed consent forms. 2.4 surgery and adjuvant therapy All patients received surgical treatment within 1 month after the end of neoadjuvant chemotherapy, of which 275 patients underwent modified radical mastectomy and 15 patients underwent breast conserving surgery. Postoperative chemotherapy was determined according to postoperative pathology and efficacy of neoadjuvant chemotherapy. 207 patients received postoperative chemotherapy, 127 patients received endocrine therapy, 40 patients received targeted therapy, and 7 patients underwent breast reconstruction. 2.5 Data collection and survival follow-up The inpatient medical records were consulted, including the patient's age, tumor location and size, cTNM staging, LNR, pathological molecular subtypes (including ER, PR, HER-2, Ki-67, etc.), neoadjuvant chemotherapy regimen, pathological complete remission rate of chemotherapy, postoperative treatment regimen, etc. The determination of cTNM staging in breast cancer patients mainly depended on breast MRI. The survey was conducted in the form of questionnaire, telephone inquiry and outpatient follow-up. The patients were followed up once every 3 or 6 months, with an average follow-up time of (20.6 ± 11.8) months. Disease free survival (DFS) refers to the time from the first day after surgery to recurrence or metastasis or the last follow-up. Overall Survival (OS) refers to the time from first days after surgery to death due to various factors or the last follow-up. During the follow-up period, 51 patients (17.6%) had recurrence or metastasis, and 7 patients died (2.4%). 2.6 Statistical analysis SPSS 22.0 software was used for data sorting and statistical analysis. The relationship between clinical features, pathological indexes, treatment regimen and pCR, recurrence and metastasis was analyzed by χ2 test, and logistic regression was used to analyze the related factors affecting the prognosis. Kaplan Meier method was used to analyze the disease-free survival and overall survival. The statistical significance level was taken as bilateral P < 0.05. 3. Result 3.1 Influencing factors of neoadjuvant chemotherapy for breast cancer Pathological complete responses were achieved in 35 of 290 women (12.1%) with breast cancer. Univariate analysis showed that patients' age, body mass index, Her-2 and chemotherapy regimen were not related to the efficacy of neoadjuvant chemotherapy to achieve pCR (P ≥ 0.05), while menopause, higher T staging and N staging, ER and PR positive and low expression of Ki-67 were less likely to achieve pCR (P < 0.05). Among the pathological molecular types, Luminal A had a lower pCR, which was statistically different from Luminal B2, HER-2 positive and triple negative breast cancer(P < 0.05), as shown in Table 1 . Multivariate logistic regression analysis showed that N staging (OR = 0.041, 95% CI = 0.012 ~ 0.134) and Ki-67 (OR = 9.340, 95% CI = 1.770 ~ 49.286) were independent influencing factors for neoadjuvant chemotherapy to achieve pCR. Patients with lower N staging and high expression of Ki-67 often had higher pCR rate, as shown in Table 2 . Table 1 Univariate Analysis of Factors Impacting pCR Features Total(N = 290) pCR(N = 35) Non pCR(N = 255) P Age[n(%)] 0.940 < 50 years 164 20(12.2) 144(87.8) ≧ 50 years 126 15(11.9) 111(88.1) Pausimenia < 0.001 Yes 104 2(1.9) 102(98.1) No 186 33(17.7) 153(82.3) BMI 0.248 < 24 159 16(10.1) 143(89.9) ≧ 24 131 19(14.5) 112(85.5) T staging 0.001 T1 28 5(17.9) 23(82.1) T2 158 28(17.7) 130(82.3) T3 58 2(3.4) 56(96.6) T4 46 0(0.0) 46(100.0) N staging < 0.001 N0 74 31(41.9) 43(58.1) N1 125 2(1.6) 123(98.4) N2 55 1(1.8) 54(98.2) N3 36 1(2.8) 35(97.2) Pathological molecular typing 0.172 Luminal A 79 4(5.1) 75(94.9) Luminal B1 17 1(5.9) 16(94.1) Luminal B2 52 8(15.4) 44(84.6) *P = 0.045 Her-2 Positive 66 10(15.2) 56(84.8) # P = 0.041 Triple negative 76 12(15.8) 64(84.2) △ P = 0.028 ER < 0.001 Positive 221 16(7.2) 205(92.8) Negative 69 19(27.5) 50(72.5) PR 0.024 Positive 175 15(8.6) 160(91.4) Negative 115 20(17.4) 95(82.6) Her-2 0.060 Positive 123 20(16.3) 103(83.7) Negative 167 15(9.0) 152(91.0) Ki-67 0.000 High expression 186 33(17.2) 153(82.8) Low expression 104 2(2.0) 102(98.0) Chemotherapy cycle 0.668 ≦ 3 cycles 54 5(9.3) 49(90.7) 4 cycles 113 15(13.3) 98(86.7) 5 cycles 23 1(4.3) 22(95.7) 6 cycles 82 12(14.6) 70(85.4) ≧ 7 cycles 18 2(11.1) 16(88.9) AC/EC programme 0.323 Yes 28 5(17.9) 23(82.1) No 262 30(11.5) 232(88.5) ET programme 0.433 Yes 100 10(10.0) 90(90.0) No 190 25(13.2) 165(86.8) TC programme 0.414 Yes 30 5(16.7) 25(83.3) No 260 30(11.5) 230(88.5) FEC programme 0.831 Yes 19 2(10.5) 17(89.5) No 271 33(12.2) 238(87.8) Note: HER-2 positive is defined as standard immunohistochemical 3+, or positive in situ hybridization; Ki-67≧14% means high expression, Ki-67<14% means low expression; Compared with luminal B2 and luminal A, * P = 0.045; Her-2 positive compared with luminal A, #p = 0.041; Triple negative compared with luminal A, △ P = 0.028. Table 2 Multivariate regression analyses for pCR Variable β Wald P OR OR95%CI Pausimenia -1.533 3.291 0.070 0.216 0.041–1.131 T staging(T1T2vsT3T4) -1.509 3.374 0.066 0.221 0.044–1.106 N staging(N0vsN1N2N3) -3.200 27.622 0.000 0.041 0.012–0.134 ER -1.177 3.497 0.061 0.308 0.090–1.058 PR 0.687 1.135 0.287 1.987 0.562–7.032 Ki-67 2.234 6.932 0.008 9.340 1.770-49.286 3.2 Factors affecting recurrence and metastasis of breast cancer During the follow-up period, a total of 51 patients had recurrence or metastasis. The recurrence and metastasis rate was 17.59%, of which bone metastasis was the most common (54.9%). Univariate analysis showed that recurrence and metastasis in breast cancer patients were related to T staging, LNR, Ki-67, postoperative chemotherapy, ET regimen and postoperative radiotherapy (P < 0.05), while age, pausimenia, body mass index, N staging, pathological molecular type, estrogen and progesterone levels, Her-2 expression level, targeted therapy, endocrine therapy, neoadjuvant chemotherapy cycle were not related to pathological complete remission (P ≥ 0.05), as shown in Table 3 . Further multivariate analysis showed that T staging (OR = 1.731, 95%CI = 1.244 ~ 2.408), LNR (OR = 2.726, 95%CI = 1.430 ~ 5.197) and Ki-67 (OR = 3.107, 95%CI = 1.395 ~ 6.920) were independent risk factors for recurrence and metastasis of breast cancer, as shown in Table 4 . Table 3 Univariate Analysis of Factors Affecting Recurrence and Metastasis Features Total (N = 290) Recurrence and metastasis (N = 51) No Recurrence and metastasis (N = 239) P Age [n(%)] 0.121 <50 years 164 34(20.7) 130(79.3) ≧50 years 126 17(13.5) 109(86.5) Pausimenia 0.522 Yes 104 16(15.4) 88(84.6) No 186 35(18.8) 151(81.2) BMI 0.991 < 24 159 28(17.6) 131(82.4) ≧ 24 131 23(17.6) 108(82.4) T staging 0.043 T1 28 4(14.3) 24(85.7) T2 158 20(12.7) 138(87.3) T3 58 16(27.6) 42(72.4) T4 46 11(23.9) 35(76.1) N staging 0.051 N0 74 9(12.2) 65(87.8) N1 125 21(16.8) 104(83.2) N2 55 9(16.4) 46(83.6) N3 36 12(33.3) 24(66.7) LNR 0.002 <0.21 181 22(12.2) 159(87.8) ≧0.21 109 29(26.6) 80(73.4) Pathological molecular typing 0.997 Luminal A 79 15(19.0) 64(81.0) Luminal B1 17 3(17.6) 14(82.4) Luminal B2 52 9(17.3) 43(82.7) Her-2 positive 66 11(16.7) 55(83.3) Triple negative 76 13(17.1) 63(82.9) ER 0.499 Positive 221 37(16.7) 184(83.3) Negative 69 14(20.3) 55(79.7) PR 0.381 Positive 175 28(16.0) 147(84.0) Negative 115 23(20.0) 92(80.0) Her-2 0.844 Positive 123 21(17.1) 102(82.9) Negative 167 30(18.0) 137(82.0) Ki-67 0.008 High express 186 41(22.0) 145(78.0) Low express 104 10(9.6) 94(90.4) Postoperative chemotherapy 0.027 Yes 207 43(20.8) 164(79.2) No 82 8(9.8) 74(90.2) Targeted therapy 0.962 Yes 40 7(17.5) 33(82.5) No 247 44(17.8) 203(82.2) Endocrine therapy 0.096 Yes 127 28(22.0) 99(78.0) No 159 23(14.5) 136(85.5) Neoadjuvant chemotherapy cycle 0.201 ≦3 cycles 54 6(11.1) 48(88.9) 4 cycles 113 17(15.0) 96(85.0) 5 cycles 23 5(21.7) 18(78.3) 6 cycles 82 17(20.7) 65(79.3) ≧ 7 cycles 18 6(33.3) 12(66.7) Radiotherapy 0.024 Yes 199 42(21.1) 157(78.9) No 89 9(10.1) 80(89.9) pCR 0.135 Yes 35 3(8.6) 32(91.4) No 255 48(18.8) 207(81.2) AC/EC regimen 0.574 Yes 28 6(21.4) 22(78.6) No 262 45(17.2) 217(82.8) ET regimen 0.014 Yes 100 10(10.0) 90(90.0) No 190 41(21.6) 149(78.4) TC regimen 0.518 Yes 30 4(18.1) 26(81.9) No 260 47(13.3) 213(86.7) FEC regimen 0.681 Yes 19 4(21.1) 15(78.9) No 271 47(17.3) 224(82.7) Note: Her-2 positive is defined as standard immunohistochemical 3+, or positive in situ hybridization; Ki-67≧14% means high expression, Ki-67<14% means low expression Table 4 Multivariate regression analyses for recurrence and metastasis Variable β Wald P OR OR95%CI T staging(T1T2vsT3T4) 0.548 10.59 0.001 1.731 1.244–2.408 LNR 1.003 9.285 0.002 2.726 1.430–5.197 ER -0.060 0.020 0.888 0.942 0.407–2.180 PR -0.117 0.098 0.755 0.890 0.427–1.853 Her-2 -0.095 0.078 0.780 0.909 0.467–1.770 Ki-67 1.134 7.702 0.006 3.107 1.395–6.920 3.3 Prognostic factors in patients with breast cancer Kaplan-Meier survival analysis showed that the breast cancer patients with Ki67 low expression or LNR < 0.21 had longer disease-free survival (P 0.05), as shown in Fig. 1 . In terms of clinical staging, T1 and T2 patients had better survival prognosis than T3 and T4 patients (DFS: P = 0.007, OS: P = 0.004), and N0, N1 and N2 patients had better survival prognosis than N3 patients (DFS: P = 0.007, OS: P = 0.004), as shown in Fig. 2 . In neoadjuvant chemotherapy, pCR and ET programme were no relationship with disease-free survival and overall survival (P > 0.05), as shown in Fig. 3 . 4. Discuss Breast cancer is a heterogeneous tumor. Different pathological indicators and clinical features of breast cancer patients often mean different sensitivity of neoadjuvant chemotherapy and survival prognosis [ 21 ]. This study found that neoadjuvant chemotherapy efficacy and survival prognosis in breast cancer patients were correlated with TNM staging, breast cancer tissue sex hormone receptor, Ki-67 expression and neoadjuvant chemotherapy, but not related to age, body mass index, neoadjuvant chemotherapy cycle, pCR and the expression of Her-2. TNM staging of breast cancer is an important prognostic indicator for breast cancer. Breast cancer patients in the early stages of TNM are generally considered to have a better prognosis. Kitajima et al [ 22 ] also found that the early staging of TNM breast cancer patients had longer disease-free survival. This study further analyzed the relationship between tumor size, lymph node metastasis and prognosis of breast cancer. It was found that T staging were closely related to recurrence and metastasis of breast cancer in TNM staging, and were independent risk factors for recurrence and metastasis of breast cancer. The results of this study indicate that breast cancer with a tumor diameter greater than 50mm is more likely to relapse or metastases after surgery and chemotherapy. Survival analysis revealed that patients with breast cancer whose diameter was larger than 50mm had shorter disease-free survival or overall survival and poorer prognosis. This is consistent with previous studies, tumor size is an important factor for the prognosis of breast cancer [ 23 , 24 ]. The relationship between TNM staging of breast cancer and the efficacy of neoadjuvant chemotherapy is still controversial. For example, Duman et al. [ 25 ] believed that TNM staging III breast cancer patients are more likely to achieve pCR after neoadjuvant chemotherapy. Del Prete et al.[ 26 ] found that the pCR rate of neoadjuvant chemotherapy in patients with T2 and T3 is even higher, but some reports also suggest that patients with breast cancer at the staging of T3 are often less sensitive to neoadjuvant chemotherapy [ 27 ]. This study found that T staging and N staging were associated with the efficacy of neoadjuvant chemotherapy. T1 and T2 staging breast cancer patients and N0 staging breast cancer patients were more likely to get pCR after neoadjuvant chemotherapy, and T staging was an independent predictor of the efficacy of neoadjuvant chemotherapy. Therefore, TNM staging is of great significance in both predicting the efficacy of neoadjuvant chemotherapy and evaluating the prognosis of breast cancer patients, especially the role of primary tumor size in curative effect prediction and prognosis evaluation of breast cancer should not be ignored. More noteworthy is the value of LNR in recurrence, metastasis and prognosis of breast cancer. This study found that LNR is an independent risk factor for breast cancer recurrence and metastasis, and is negatively correlated with prognosis. Meta-analysis of LNR showed that lymph node ratio is an independent predictive factor for the prognosis of breast cancer patients after neoadjuvant chemotherapy [ 28 ]. Breast cancer is a hormone dependent tumor. Its growth is regulated by ER and PR. ER and PR have been widely recognized as prognostic indicators of endocrine therapy for breast cancer. In recent years, ER and PR as the predictive indicators of the efficacy of neoadjuvant chemotherapy have been gradually taken seriously. Many studies have shown that patients with ER and PR negative breast cancer are more likely to achieve pCR [ 29 , 30 ]. This study also found that patients with ER and PR negative breast cancer often had better efficacy and higher pCR than those with positive ER and PR expression after neoadjuvant chemotherapy. The results suggest that ER and PR negative breast cancer cells may be more sensitive to chemotherapy drugs. The reason may be that the expression level of ER and PR is related to the degree of differentiation of breast cancer. The expression of ER and PR in breast cancer indicates that breast cancer cells still retain the characteristics of hormone dependent growth, and the degree of cell differentiation is high, whereas ER and PR negative breast cancer cells malignant degree is high, the proliferation of hyperplasia more exuberant, and therefore more sensitive to chemotherapy drugs that block cell growth and reproduction [ 31 , 32 ]. For survival prognosis, this study found that the level of ER expression had no significant effect on the disease-free survival and overall survival. Breast cancer with negative ER, PR and HER-2 is triple negative breast cancer. According to many studies [ 33 ], triple negative breast cancer is more likely to obtain pathological complete remission with neoadjuvant chemotherapy than other types of breast cancer, but it also has a higher risk of metastasis and recurrence. This study found that the pCR rate of neoadjuvant chemotherapy for triple negative breast cancer and Her-2 positive breast cancer was higher than that of Luminal A type breast cancer, but there was no significant difference in survival prognosis between different types of breast cancer. Tulbah et al. [ 34 ] also believed that Her-2 expression level before neoadjuvant chemotherapy could not be used as an indicator to predict tumor sensitivity to neoadjuvant chemotherapy and prognosis. The reason for this difference may be that there are many factors affecting the efficacy and prognosis of chemotherapy. For example, different chemotherapy regimens and follow-up time can have differences on the results, which needs further large sample long-term follow-up study. Ki67 is a proliferating cell related antigen, which can reflect the proliferative activity of tumor cells. This study showed that breast cancer patients with high Ki67 expression had a higher pCR rate of neoadjuvant chemotherapy and were more sensitive to chemotherapy, and Ki67 was an independent predictor of the efficacy of neoadjuvant chemotherapy. Jain et al. [ 35 ] also made similar findings, and believed that Ki67 > 35% was an independent predictor of pCR in neoadjuvant chemotherapy. Chen et al. [ 36 ] considered that the expression level of Ki67 could predict the efficacy of neoadjuvant chemotherapy containing anthracycline through meta-analysis. It should be noted that although the high expression of Ki67 means high sensitivity to chemotherapy, it also indicates high proliferative activity. This study found that breast cancer patients with high expression of Ki67 were more likely to have recurrence and metastasis, and were independent risk factors for recurrence and metastasis of breast cancer. Although the overall survival of breast cancer patients with high Ki67 expression had no significant difference compared with those with low Ki67 expression, their disease-free survival was shorter. Gunter et al. [ 37 ] also showed that patients with high Ki67 expression had a higher risk of disease recurrence and death. It can be seen that Ki67 is one of the biological indicators with good research prospects to predict the efficacy of neoadjuvant chemotherapy and disease-free survival. Different neoadjuvant chemotherapy regimens have different effects on chemotherapy efficacy of breast cancer and prognosis. This study evaluated the efficacy and prognosis of commonly used neoadjuvant chemotherapy regimens (AC, EC, ET, TC and FEC) for breast cancer. It was found that there was no significant difference in the efficacy and survival prognosis of these neoadjuvant chemotherapy regimens, but the probability of recurrence or metastasis of breast cancer patients using ET regimen was lower than that of other chemotherapy regimens. The ET regimen may be a protective factor for recurrence or metastasis of breast cancer. The ET regimen includes epirubicin and taxotere. Previous studies [ 38 – 40 ] have also shown that neoadjuvant chemotherapy with taxotere and epirubicin has good curative effect, and the survival prognosis of epirubicin combined with taxotere is better than that of epirubicin alone. In addition to the selection and application of chemotherapy drugs, the dose density and intensity of drug use will also affect the clinical efficacy and prognosis [ 41 ]. Therefore, the role of ET regimen in inhibiting recurrence or metastasis of breast cancer needs to be further refined. In addition, this study also found that patients with no postoperative chemotherapy was related to lower risk of recurrence and metastasis. The possible reason is that we evaluated the postoperative pathology and the efficacy of neoadjuvant chemotherapy, and those patients with worse pathology and efficacy of neoadjuvant chemotherapy received postoperative chemotherapy. In many studies of neoadjuvant chemotherapy, pCR has been regarded as one of the most important quantitative indicators of chemotherapy response, and it is considered to be an early signal to improve the prognosis of patients, and may replace DFS and OS [ 42 , 43 ]. This study found that there was no significant correlation between pCR and recurrence or metastasis of breast cancer and prognosis of patients. pCR may not be a good indicator of survival. As mentioned above, breast cancer patients with high expression of Ki67 are more sensitive to neoadjuvant chemotherapy, and the pCR rate is higher than that of patients with low Ki67 expression. However, the prognosis of patients with high Ki67 expression is often poor. Some previous studies also did not support the use of pCR rates of neoadjuvant chemotherapy as an alternative endpoint for disease-free survival and overall survival [ 44 , 45 ]. Therefore, we think that in the same pathological index (such as similar Ki67 expression level) or the same pathological molecular type (such as triple negative breast cancer) or similar invasive breast cancer cells, and so on, the prognosis of breast cancer patients is predicted by pCR. To sum up, the efficacy of neoadjuvant chemotherapy and survival prognosis of breast cancer patients are influenced by many indicators, especially the role of T staging, LNR and Ki67 expression. Considering the reactivity of chemotherapy and the prognosis of patients are complex processes which are affected by many factors. Considering that chemotherapeutic response and patient prognosis are complex processes affected by multiple factors, the combination of more indicators, such as molecular biomarkers and multi-gene testing, may be more beneficial to predict results, and at the same time can make the treatment of breast cancer more effective and more targeted. Due to the retrospective study, small sample size, short follow-up time and insufficiently detailed index classification, this study still has some limitations and needs to be further improved in future studies. 5. Conclusions In conclusion, Our study found that clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy were related to cTNM staging, LNR, ER/PR, and Ki-67. Declarations Author Contributions T.B. wrote the first draft of this paper, and Z.X. revised this paper. 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Neoadjuvant Chemotherapy Plays an Adverse Role in the Prognosis of Grade 2 Breast Cancer. Journal of Cancer. 2019;10:5661-70. McTiernan A. Weight, physical activity and breast cancer survival. The Proceedings of the Nutrition Society. 2018;77:403-11. Tantivatana T, Chongthanakorn M, Rongsriyam K, Katanyoo K. Treatment outcomes and prognostic factors of patients with breast cancer: a retrospective review. Journal of the Medical Association of Thailand. 2009;92:1084-93. Martínez-Trufero J, de Lobera AR, Lao J, Puértolas T, Artal-Cortés A, Zorrilla M, et al. Serum markers and prognosis in locally advanced breast cancer. Tumori. 2005;91:522-30. Dai XL, Han ZB, Yang YT, Qiu J, Liu YF, Feng YZ. Efficacy and prognosis of neoadjuvant chemotherapy is correlated with breast cancer molecular classification. International journal of clinical pharmacology and therapeutics. 2015;53:517-22. Cho DH, Bae SY, You JY, Kim HK, Chang YW, Choi YJ, et al. Lymph node ratio as an alternative to pN staging for predicting prognosis after neoadjuvant chemotherapy in breast cancer. Kaohsiung J Med Sci. 2018;34(6):341-7. Ai X, Liao X, Wang M, Hu Y, Li J, Zhang Y, et al. Prognostic value of lymph node ratio in breast cancer patients with adequate pathologic evidence after neoadjuvant chemotherapy. Med Sci Monit. 2020;26:e922420. Harbeck N, Thomssen C, Gnant M. St. Gallen 2013: brief preliminary summary of the consensus discussion. Breast Care (Basel). 2013;8:102-9. Winder AA, Dijkstra B. Is pathological complete response predictable after neoadjuvant chemotherapy in breast cancer? A single institution's retrospective experience. ANZ JOURNAL OF SURGERY. 2021;91:1779-1783. Kitajima K, Nakatani K, Yamaguchi K, Nakajo M, Tani A, Ishibashi M, et al. Response to neoadjuvant chemotherapy for breast cancer judged by PERCIST - multicenter study in Japan. European journal of nuclear medicine and molecular imaging. 2018;45:1661-71. Huang Z, Jin S, Zeng M, Shu J, Liu Y, Zhang J, et al. Clinical and Therapeutic Factors Vary by Prognosis in Patients with Pathological Complete Response After Neoadjuvant Therapy for Breast Cancer. Cancer Management and Research. 2021;13:9235-9246. Rostami R, Mittal S, Rostami P, Tavassoli F, Jabbari B. Brain metastasis in breast cancer: a comprehensive literature review. J Neurooncol. 2016;127:407-14. Duman BB, Afşar ÇU, Günaldi M, Sahin B, Kara IO, Erkisi M, et al. Retrospective analysis of neoadjuvant chemotherapy for breast cancer in Turkish patients. Asian Pacific journal of cancer prevention : APJCP. 2012;13:4119-23. Del Prete S, Caraglia M, Luce A, Montella L, Galizia G, Sperlongano P, et al. Clinical and pathological factors predictive of response to neoadjuvant chemotherapy in breast cancer: A single center experience. Oncology letters. 2019;18:3873-9. Livingston-Rosanoff D, Schumacher J, Vande Walle K, Stankowski-Drengler T, Greenberg CC, Neuman H, et al. Does Tumor Size Predict Response to Neoadjuvant Chemotherapy in the Modern Era of Biologically Driven Treatment? A Nationwide Study of US Breast Cancer Patients. Clinical breast cancer. 2019;19:e741-e7. Liu J, Li Y, Zhang W, Yang C, Yang C, Chen L, et al. The prognostic role of lymph node ratio in breast cancer patients received neoadjuvant chemotherapy: A dose-response meta-analysis. Front Surg. 2022;9:971030. Caldana M, Pellini F, Lombardi D, Mirandola S, Invento A, Pollini GP. Breast cancer and neoadjuvant chemotherapy: indications for and limits of breast-conserving surgery. Annali italiani di chirurgia. 2018;89:392-7. Nakatsukasa K, Koyama H, Oouchi Y, Imanishi S, Mizuta N, Sakaguchi K, et al. Docetaxel and cyclophosphamide as neoadjuvant chemotherapy in HER2-negative primary breast cancer. Breast cancer. 2017;24:63-8. Arciero CA, Guo Y, Jiang R, Behera M, O'Regan R, Peng L, et al. ER+/HER2+ Breast Cancer Has Different Metastatic Patterns and Better Survival Than ER-/HER2+ Breast Cancer. Clin Breast Cancer. 2019;19:236-245. Giulianelli S, Lamb CA, Lanari C. Progesterone receptors in normal breast development and breast cancer. Essays Biochem. 2021;65:951-969. Kumar P, Aggarwal R. An overview of triple-negative breast cancer. Archives of gynecology and obstetrics. 2016;293:247-69. Tulbah AM, Ibrahim EM, Ezzat AA, Ajarim DS, Rahal MM, El Weshi AN, et al. HER-2/Neu overexpression does not predict response to neoadjuvant chemotherapy or prognosticate survival in patients with locally advanced breast cancer. Medical oncology. 2002;19:15-23. Jain P, Doval DC, Batra U, Goyal P, Bothra SJ, Agarwal C, et al. Ki-67 labeling index as a predictor of response to neoadjuvant chemotherapy in breast cancer. Japanese journal of clinical oncology. 2019;49:329-38. Chen X, He C, Han D, Zhou M, Wang Q, Tian J, et al. The predictive value of Ki-67 before neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis. Future oncology. 2017;13:843-57. Von Minckwitz G, Schmitt WD, Loibl S, Müller BM, Blohmer JU, Sinn BV, et al. Ki67 measured after neoadjuvant chemotherapy for primary breast cancer. Clinical cancer research : an official journal of the American Association for Cancer Research. 2013;19:4521-31. Won HS, Kim YS, Kim JS, Chang ED, Na SJ, Whang IY, et al. Clinical outcome and predictive factors for docetaxel and epirubicin neoadjuvant chemotherapy of locally advanced breast cancer. The Korean journal of internal medicine. 2020;35:1489-96. Lombardi D, Scalone S, Crivellari D, Magri MD, La Mura N, Miolo G, et al. Epirubicin and docetaxel as neoadjuvant treatment of locally advanced breast cancer: a phase II study. Tumori. 2010;96:229-33. Coombes RC, Bliss JM, Espie M, Erdkamp F, Wals J, Tres A, et al. Randomized, phase III trial of sequential epirubicin and docetaxel versus epirubicin alone in postmenopausal patients with node-positive breast cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2011;29:3247-54. Pathak M, Dwivedi SN, Deo SVS, Thakur B, Sreenivas V, Rath GK. Neoadjuvant chemotherapy regimens in treatment of breast cancer: a systematic review and network meta-analysis protocol. Syst Rev. 2018;7:89. Spring L, Greenup R, Niemierko A, Schapira L, Haddad S, Jimenez R, et al. Pathologic Complete Response After Neoadjuvant Chemotherapy and Long-Term Outcomes Among Young Women With Breast Cancer. Journal of the National Comprehensive Cancer Network : JNCCN. 2017;15:1216-23. Jinga DC, Jinga MR, Miron A, Noditi A, Blidaru A. Pathological Response and Survival after Neoadjuvant Therapy for Her-2 Positive Breast Cancer. Chirurgia (Bucur). 2021;116:91-97. Tang S, Wang K, Zheng K, Liu J, Zhang H, Tan M, et al. Clinical and pathological response to neoadjuvant chemotherapy with different chemotherapy regimens predicts the outcome of locally advanced breast cancer. Gland Surg. 2020;9:1415-1427. Ryu YJ, Kang SJ, Cho JS, Yoon JH, Park MH. Lymphovascular invasion can be better than pathologic complete response to predict prognosis in breast cancer treated with neoadjuvant chemotherapy. Medicine (Baltimore). 2018;97:e11647. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2552365","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":173828667,"identity":"feb9c69c-3a62-456e-b069-6b48a4bea185","order_by":0,"name":"binbin tang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxklEQVRIiWNgGAWjYBAC+2aGhAMJFWxy9scbiNRiwN7w8MGHM3zGDGcOEKuF5+Bjw5ltcokNNxKI1GIukZwmzdtmltg48/HGGww1NtEEtVjOSEuT5jmXZtwsnVZswXAsLbeBoJ4bOUAtZcdk26RzzCQYGw4ToyX/mzQP23/GHskzRGoxOHMg2XBGG5viDAkeIrVItjckAgOZzdiAB+iXBGL8ws8MjUoD9sMbb3yosSHCL8iOlEggRTlEC6k6RsEoGAWjYGQAAJlFQuhbjw2HAAAAAElFTkSuQmCC","orcid":"","institution":"Tongde Hospital of Zhejiang Province","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"binbin","middleName":"","lastName":"tang","suffix":""},{"id":173828668,"identity":"d239b008-46cd-4e43-a664-06504c83a82d","order_by":1,"name":"Zhang xiping","email":"","orcid":"","institution":"Zhejiang Cancer Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhang","middleName":"","lastName":"xiping","suffix":""}],"badges":[],"createdAt":"2023-02-05 10:44:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2552365/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2552365/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":32944087,"identity":"f55caf45-b973-4ea9-ae6f-4dac9d5e3dfe","added_by":"auto","created_at":"2023-02-14 22:06:41","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":203914,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurvival curves for DFS and OS according to Ki67 and LNR. \u003c/strong\u003eKi-67 negative patients had longer disease-free survival (P=0.007), while the overall survival was not significantly different from those of Ki-67 positive patients (P\u0026gt;0.05). When LNR\u0026lt;0.21, patients with breast cancer had longer disease-free survival (P=0.022), but there was no significant correlation between overall survival and LNR (P\u0026gt;0.05).\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2552365/v1/51e43f36fc1cff5281bb7407.jpg"},{"id":32944089,"identity":"27cdd747-6223-419c-a424-e1c9be64774e","added_by":"auto","created_at":"2023-02-14 22:06:42","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":212380,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurvival curves for DFS and OS according to T staging and N staging. \u003c/strong\u003eT1 and T2 patients had better survival prognosis than T3 and T4 patients (DFS: P = 0.007, OS: P = 0.004), and N0, N1 and N2 patients had better survival prognosis than N3 patients (DFS: P = 0.007, OS: P = 0.004).\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2552365/v1/cb3386e98641da5652bbab1b.jpg"},{"id":32944088,"identity":"5b4cdc99-7280-4e85-ab8d-54747f98a966","added_by":"auto","created_at":"2023-02-14 22:06:42","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":205498,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurvival curves for DFS and OS according to pCR and ET-Chemotherapy\u003c/strong\u003e. pCR and ET regimen were no relationship with disease-free survival and overall survival (P \u0026gt;0.05).\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2552365/v1/39801a2e10c773f7a67e827d.jpg"},{"id":41155890,"identity":"9ea2ee27-110e-4ef4-9a2c-9edfec868cd5","added_by":"auto","created_at":"2023-08-07 06:07:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":671292,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2552365/v1/970eb0e5-5dca-45b2-ad0a-208cf1d0fe02.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The influence factors of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eBreast cancer is the most common malignancy in women, which is a serious threat to women's life quality and health. According to a statistic from the American Cancer Society [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], breast cancer ranks first in the incidence of new malignant tumors in women, with an annual increase of about 0.3% in the past five years, and the incidence is the highest among white people. China is also a country with a high incidence of breast cancer. According to the statistics of China Cancer Center in 2018 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e], the cases and deaths of female breast cancer accounted for 11.2% and 9.2% of the global incidence and mortality respectively, ranking among the highest in the world. With the gradual improvement of the level of breast cancer screening and early screening, early breast cancer has been found and treated in time, but there are still a lot of patients with local advanced breast cancer, which is still a very prominent clinical problem worldwide [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Neoadjuvant chemotherapy is a standard treatment for locally advanced breast cancer. It has the advantages of inhibiting systemic micrometastasis, reducing tumor size, reducing tumor staging, improving surgical methods and evaluating tumor sensitivity to chemotherapy[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt present, the pCR rate of neoadjuvant chemotherapy for breast cancer patients is not ideal [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. There are great differences in prognosis and response of different patients after chemotherapy. At present, there is no consensus on the predictors of neoadjuvant chemotherapy efficacy. Studies have found that the efficacy of neoadjuvant chemotherapy may be related to a variety of clinical and pathological indicators [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], such as tumor size, lymph node metastasis,tumor infiltrating lymphocytes and pathological molecular subtypes. In addition, it is generally believed that pathological complete remission after neoadjuvant chemotherapy is closely related to the disease-free survival and overall survival of breast cancer patients. Patients with complete pathological remission often have a better prognosis [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, some studies [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] have shown that neoadjuvant chemotherapy has no correlation with prognosis and even has adverse effects. This may be because there are many factors affecting prognosis, such as BMI[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], TNM stage [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], tumor markers [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], pathological molecular types [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], etc. In addition, some studies have found that the lymph node ratio (LNR) is an independent risk factor for prognosis of breast cancer patients, and is more valuable than N stage [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. This study investigated and followed up 290 female breast cancer patients in our hospital with neoadjuvant chemotherapy efficacy and prognosis, and analyzed the relationship with clinical characteristics, pathological indicators and treatment plan of the patients.\u003c/p\u003e"},{"header":"2. Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Case selection\u003c/h2\u003e \u003cp\u003eA retrospective study was conducted on female breast cancer patients who received neoadjuvant chemotherapy from December 2012 to December 2017 in Zhejiang Cancer Hospital. The criteria were as follows: ① breast cancer was diagnosed by pathological diagnosis. ② It has relatively complete clinical and pathological data. Exclusion criteria: ① serious lack of follow-up data; ② communication barriers; (3) bilateral breast cancer patients; ④ combined with other malignant tumors or major diseases affecting the dysfunction of important organs. After screening, a total of 290 women with breast cancer were enrolled in this study. The youngest was 14 years old, the oldest was 74 years old, with an average age of (48.4\u0026thinsp;\u0026plusmn;\u0026thinsp;8.7) years.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Molecular typing criteria\u003c/h2\u003e \u003cp\u003eImmunohistochemical method was used to determine the molecular typing. The molecular typing standard was according to the 2013 St. Gallen Guide [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]:Luminal type A was ER positive and / or PR positive, HER-2 negative, Ki-67\u0026thinsp;\u0026lt;\u0026thinsp;14%;Luminal B1 was ER positive and / or PR positive, HER-2 negative, Ki-67\u0026thinsp;\u0026ge;\u0026thinsp;14%;Luminal B2 was ER positive and / or PR positive, HER-2 positive and Ki-67 at any level;HER-2 overexpression type (HER-2 positive type): ER and PR deletion, HER-2 overexpression; Triple negative: ER and PR deletion, HER-2 negative.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Neoadjuvant chemotherapy scheme and efficacy judgment\u003c/h2\u003e \u003cp\u003ePatients and their families were informed of their detailed condition, treatment plan, chemotherapy risks and precautions, and preoperative neoadjuvant chemotherapy was performed after signing the chemotherapy consent form. Neoadjuvant chemotherapy regimen mainly include ET regimen (Epirubicin and Taxotere regimen, 34.5%), TC regimen (Taxotere and Cyclophosphamide regimen, 10.3%), AC or EC regimen (Adriamycin/Epirubicin and Cyclophosphamide, 9.7%), FEC regimen(Fluorouracil, Epirubicin and Cyclophosphamide regimen, 6.6%). If HER-2 is overexpressed, it will be combined with targeted therapy, mainly EC * 4 followed byTH (Taxotere and Herceptin) * 4 or TCH (Taxotere, Cyclophosphamide and Herceptin) * 6. Breast MRI was evaluated before and every 2 cycles of neoadjuvant chemotherapy to determine whether to change chemotherapy regimen and cycle. Pathological complete remission (pCR) criteria: there were no residual invasive cancer cells or only residual cancer components in situ in postoperative breast tissue, and lymph node metastatic lesions disappeared completely. The study was approved by Zhejiang Cancer Hospital, and all participants signed informed consent forms.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 surgery and adjuvant therapy\u003c/h2\u003e \u003cp\u003eAll patients received surgical treatment within 1 month after the end of neoadjuvant chemotherapy, of which 275 patients underwent modified radical mastectomy and 15 patients underwent breast conserving surgery. Postoperative chemotherapy was determined according to postoperative pathology and efficacy of neoadjuvant chemotherapy. 207 patients received postoperative chemotherapy, 127 patients received endocrine therapy, 40 patients received targeted therapy, and 7 patients underwent breast reconstruction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data collection and survival follow-up\u003c/h2\u003e \u003cp\u003eThe inpatient medical records were consulted, including the patient's age, tumor location and size, cTNM staging, LNR, pathological molecular subtypes (including ER, PR, HER-2, Ki-67, etc.), neoadjuvant chemotherapy regimen, pathological complete remission rate of chemotherapy, postoperative treatment regimen, etc. The determination of cTNM staging in breast cancer patients mainly depended on breast MRI. The survey was conducted in the form of questionnaire, telephone inquiry and outpatient follow-up. The patients were followed up once every 3 or 6 months, with an average follow-up time of (20.6\u0026thinsp;\u0026plusmn;\u0026thinsp;11.8) months. Disease free survival (DFS) refers to the time from the first day after surgery to recurrence or metastasis or the last follow-up. Overall Survival (OS) refers to the time from first days after surgery to death due to various factors or the last follow-up. During the follow-up period, 51 patients (17.6%) had recurrence or metastasis, and 7 patients died (2.4%).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Statistical analysis\u003c/h2\u003e \u003cp\u003eSPSS 22.0 software was used for data sorting and statistical analysis. The relationship between clinical features, pathological indexes, treatment regimen and pCR, recurrence and metastasis was analyzed by χ2 test, and logistic regression was used to analyze the related factors affecting the prognosis. Kaplan Meier method was used to analyze the disease-free survival and overall survival. The statistical significance level was taken as bilateral P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Result","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n\u003ch2\u003e3.1 Influencing factors of neoadjuvant chemotherapy for breast cancer\u003c/h2\u003e\n\u003cp\u003ePathological complete responses were achieved in 35 of 290 women (12.1%) with breast cancer. Univariate analysis showed that patients' age, body mass index, Her-2 and chemotherapy regimen were not related to the efficacy of neoadjuvant chemotherapy to achieve pCR (P\u0026thinsp;\u0026ge;\u0026thinsp;0.05), while menopause, higher T staging and N staging, ER and PR positive and low expression of Ki-67 were less likely to achieve pCR (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Among the pathological molecular types, Luminal A had a lower pCR, which was statistically different from Luminal B2, HER-2 positive and triple negative breast cancer(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Multivariate logistic regression analysis showed that N staging (OR\u0026thinsp;=\u0026thinsp;0.041, 95% CI\u0026thinsp;=\u0026thinsp;0.012\u0026thinsp;~\u0026thinsp;0.134) and Ki-67 (OR\u0026thinsp;=\u0026thinsp;9.340, 95% CI\u0026thinsp;=\u0026thinsp;1.770\u0026thinsp;~\u0026thinsp;49.286) were independent influencing factors for neoadjuvant chemotherapy to achieve pCR. Patients with lower N staging and high expression of Ki-67 often had higher pCR rate, as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eUnivariate Analysis of Factors Impacting pCR\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFeatures\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal(N\u0026thinsp;=\u0026thinsp;290)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003epCR(N\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNon pCR(N\u0026thinsp;=\u0026thinsp;255)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge[n(%)]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.940\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;50 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e164\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20(12.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e144(87.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧\u0026thinsp;50 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e126\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(11.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e111(88.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePausimenia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e104\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(1.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e102(98.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e186\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33(17.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e153(82.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.248\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e159\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(10.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e143(89.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧\u0026thinsp;24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e131\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19(14.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e112(85.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT staging\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(17.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23(82.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28(17.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130(82.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(3.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e56(96.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46(100.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN staging\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31(41.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e43(58.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e125\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(1.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e123(98.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(1.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e54(98.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(2.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35(97.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ePathological molecular typing\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.172\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal A\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(5.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75(94.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal B1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(5.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(94.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal B2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8(15.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44(84.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e*P\u0026thinsp;=\u0026thinsp;0.045\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHer-2 Positive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(15.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e56(84.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003csup\u003e#\u003c/sup\u003eP\u0026thinsp;=\u0026thinsp;0.041\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTriple negative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12(15.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e64(84.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003csup\u003e△\u003c/sup\u003eP\u0026thinsp;=\u0026thinsp;0.028\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e221\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(7.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e205(92.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19(27.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50(72.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.024\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e175\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(8.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e160(91.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e115\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20(17.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e95(82.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHer-2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.060\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e123\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20(16.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e103(83.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e167\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(9.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e152(91.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKi-67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh expression\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e186\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33(17.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e153(82.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLow expression\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e104\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(2.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e102(98.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eChemotherapy cycle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.668\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≦\u0026thinsp;3 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(9.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e49(90.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e113\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(13.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e98(86.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1(4.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22(95.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12(14.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e70(85.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧\u0026thinsp;7 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(11.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(88.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAC/EC programme\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.323\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(17.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23(82.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e262\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30(11.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e232(88.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eET programme\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.433\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(10.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e90(90.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e190\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25(13.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e165(86.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTC programme\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.414\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(16.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25(83.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e260\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30(11.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e230(88.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFEC programme\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.831\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2(10.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17(89.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e271\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33(12.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e238(87.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: HER-2 positive is defined as standard immunohistochemical 3+, or positive in situ hybridization; Ki-67≧14% means high expression, Ki-67\u0026lt;14% means low expression; Compared with luminal B2 and luminal A, * P = 0.045; Her-2 positive compared with luminal A, #p = 0.041; Triple negative compared with luminal A, △ P = 0.028.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMultivariate regression analyses for pCR\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eVariable\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u0026beta;\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eWald\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOR95%CI\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePausimenia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-1.533\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.291\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.070\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.216\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.041\u0026ndash;1.131\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT staging(T1T2vsT3T4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-1.509\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.374\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.066\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.221\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.044\u0026ndash;1.106\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN staging(N0vsN1N2N3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-3.200\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27.622\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.041\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.012\u0026ndash;0.134\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-1.177\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.497\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.061\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.308\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.090\u0026ndash;1.058\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.687\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.135\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.287\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.987\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.562\u0026ndash;7.032\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKi-67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.234\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.932\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.008\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.340\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.770-49.286\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n\u003ch2\u003e3.2 Factors affecting recurrence and metastasis of breast cancer\u003c/h2\u003e\n\u003cp\u003eDuring the follow-up period, a total of 51 patients had recurrence or metastasis. The recurrence and metastasis rate was 17.59%, of which bone metastasis was the most common (54.9%). Univariate analysis showed that recurrence and metastasis in breast cancer patients were related to T staging, LNR, Ki-67, postoperative chemotherapy, ET regimen and postoperative radiotherapy (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while age, pausimenia, body mass index, N staging, pathological molecular type, estrogen and progesterone levels, Her-2 expression level, targeted therapy, endocrine therapy, neoadjuvant chemotherapy cycle were not related to pathological complete remission (P\u0026thinsp;\u0026ge;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Further multivariate analysis showed that T staging (OR\u0026thinsp;=\u0026thinsp;1.731, 95%CI\u0026thinsp;=\u0026thinsp;1.244\u0026thinsp;~\u0026thinsp;2.408), LNR (OR\u0026thinsp;=\u0026thinsp;2.726, 95%CI\u0026thinsp;=\u0026thinsp;1.430\u0026thinsp;~\u0026thinsp;5.197) and Ki-67 (OR\u0026thinsp;=\u0026thinsp;3.107, 95%CI\u0026thinsp;=\u0026thinsp;1.395\u0026thinsp;~\u0026thinsp;6.920) were independent risk factors for recurrence and metastasis of breast cancer, as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eUnivariate Analysis of Factors Affecting Recurrence and Metastasis\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFeatures\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal (N\u0026thinsp;=\u0026thinsp;290)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eRecurrence and metastasis (N\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNo Recurrence and metastasis (N\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge [n(%)]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.121\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;50 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e164\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34(20.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e130(79.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧50 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e126\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17(13.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e109(86.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePausimenia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.522\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e104\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(15.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e88(84.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e186\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35(18.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e151(81.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.991\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e159\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28(17.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e131(82.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧\u0026thinsp;24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e131\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23(17.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e108(82.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT staging\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.043\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(14.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(85.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e20(12.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e138(87.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16(27.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e42(72.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11(23.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35(76.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN staging\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.051\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9(12.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65(87.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e125\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21(16.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104(83.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9(16.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46(83.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eN3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12(33.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(66.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLNR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e181\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22(12.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e159(87.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧0.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e109\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29(26.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e80(73.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ePathological molecular typing\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.997\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal A\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15(19.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e64(81.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal B1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(17.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14(82.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLuminal B2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9(17.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43(82.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHer-2 positive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11(16.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55(83.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTriple negative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13(17.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e63(82.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.499\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e221\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37(16.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e184(83.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14(20.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55(79.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.381\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e175\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28(16.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e147(84.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e115\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23(20.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e92(80.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHer-2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.844\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePositive\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e123\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21(17.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e102(82.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNegative\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e167\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30(18.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e137(82.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKi-67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.008\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHigh express\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e186\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41(22.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e145(78.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLow express\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e104\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(9.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e94(90.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ePostoperative chemotherapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.027\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e207\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e43(20.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e164(79.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e8(9.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e74(90.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTargeted therapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.962\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7(17.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e33(82.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e247\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44(17.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e203(82.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eEndocrine therapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.096\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e127\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28(22.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e99(78.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e159\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23(14.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e136(85.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eNeoadjuvant chemotherapy cycle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.201\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≦3 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6(11.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e48(88.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e113\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17(15.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e96(85.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5(21.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18(78.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17(20.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65(79.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e≧\u0026thinsp;7 cycles\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6(33.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12(66.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRadiotherapy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.024\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e199\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e42(21.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e157(78.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9(10.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e80(89.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epCR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.135\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3(8.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32(91.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e255\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e48(18.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e207(81.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eAC/EC regimen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.574\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6(21.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22(78.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e262\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e45(17.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e217(82.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eET regimen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.014\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10(10.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e90(90.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e190\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41(21.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e149(78.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTC regimen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.518\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(18.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26(81.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e260\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e47(13.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e213(86.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFEC regimen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.681\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4(21.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15(78.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e271\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e47(17.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e224(82.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: Her-2 positive is defined as standard immunohistochemical 3+, or positive in situ hybridization; Ki-67≧14% means high expression, Ki-67\u0026lt;14% means low expression\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMultivariate regression analyses for recurrence and metastasis\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eVariable\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u0026beta;\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eWald\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOR95%CI\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eT staging(T1T2vsT3T4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.548\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.731\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.244\u0026ndash;2.408\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLNR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.003\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.285\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.726\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.430\u0026ndash;5.197\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.060\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.020\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.888\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.942\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.407\u0026ndash;2.180\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePR\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.117\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.098\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.755\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.890\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.427\u0026ndash;1.853\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHer-2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.095\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.078\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.780\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.909\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.467\u0026ndash;1.770\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKi-67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.134\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.702\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.107\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.395\u0026ndash;6.920\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003ch2\u003e3.3 Prognostic factors in patients with breast cancer\u003c/h2\u003e\n\u003cp\u003eKaplan-Meier survival analysis showed that the breast cancer patients with Ki67 low expression or LNR\u0026thinsp;\u0026lt;\u0026thinsp;0.21 had longer disease-free survival (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while the overall survival was not significantly different from those of Ki-67 high expression or LNR\u0026thinsp;≧\u0026thinsp;0.21 (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. In terms of clinical staging, T1 and T2 patients had better survival prognosis than T3 and T4 patients (DFS: P\u0026thinsp;=\u0026thinsp;0.007, OS: P\u0026thinsp;=\u0026thinsp;0.004), and N0, N1 and N2 patients had better survival prognosis than N3 patients (DFS: P\u0026thinsp;=\u0026thinsp;0.007, OS: P\u0026thinsp;=\u0026thinsp;0.004), as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. In neoadjuvant chemotherapy, pCR and ET programme were no relationship with disease-free survival and overall survival (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"4. Discuss","content":"\u003cp\u003eBreast cancer is a heterogeneous tumor. Different pathological indicators and clinical features of breast cancer patients often mean different sensitivity of neoadjuvant chemotherapy and survival prognosis [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This study found that neoadjuvant chemotherapy efficacy and survival prognosis in breast cancer patients were correlated with TNM staging, breast cancer tissue sex hormone receptor, Ki-67 expression and neoadjuvant chemotherapy, but not related to age, body mass index, neoadjuvant chemotherapy cycle, pCR and the expression of Her-2.\u003c/p\u003e \u003cp\u003eTNM staging of breast cancer is an important prognostic indicator for breast cancer. Breast cancer patients in the early stages of TNM are generally considered to have a better prognosis. Kitajima et al [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] also found that the early staging of TNM breast cancer patients had longer disease-free survival. This study further analyzed the relationship between tumor size, lymph node metastasis and prognosis of breast cancer. It was found that T staging were closely related to recurrence and metastasis of breast cancer in TNM staging, and were independent risk factors for recurrence and metastasis of breast cancer. The results of this study indicate that breast cancer with a tumor diameter greater than 50mm is more likely to relapse or metastases after surgery and chemotherapy. Survival analysis revealed that patients with breast cancer whose diameter was larger than 50mm had shorter disease-free survival or overall survival and poorer prognosis. This is consistent with previous studies, tumor size is an important factor for the prognosis of breast cancer [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The relationship between TNM staging of breast cancer and the efficacy of neoadjuvant chemotherapy is still controversial. For example, Duman et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] believed that TNM staging III breast cancer patients are more likely to achieve pCR after neoadjuvant chemotherapy. Del Prete et al.[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] found that the pCR rate of neoadjuvant chemotherapy in patients with T2 and T3 is even higher, but some reports also suggest that patients with breast cancer at the staging of T3 are often less sensitive to neoadjuvant chemotherapy [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. This study found that T staging and N staging were associated with the efficacy of neoadjuvant chemotherapy. T1 and T2 staging breast cancer patients and N0 staging breast cancer patients were more likely to get pCR after neoadjuvant chemotherapy, and T staging was an independent predictor of the efficacy of neoadjuvant chemotherapy. Therefore, TNM staging is of great significance in both predicting the efficacy of neoadjuvant chemotherapy and evaluating the prognosis of breast cancer patients, especially the role of primary tumor size in curative effect prediction and prognosis evaluation of breast cancer should not be ignored. More noteworthy is the value of LNR in recurrence, metastasis and prognosis of breast cancer. This study found that LNR is an independent risk factor for breast cancer recurrence and metastasis, and is negatively correlated with prognosis. Meta-analysis of LNR showed that lymph node ratio is an independent predictive factor for the prognosis of breast cancer patients after neoadjuvant chemotherapy [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBreast cancer is a hormone dependent tumor. Its growth is regulated by ER and PR. ER and PR have been widely recognized as prognostic indicators of endocrine therapy for breast cancer. In recent years, ER and PR as the predictive indicators of the efficacy of neoadjuvant chemotherapy have been gradually taken seriously. Many studies have shown that patients with ER and PR negative breast cancer are more likely to achieve pCR [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. This study also found that patients with ER and PR negative breast cancer often had better efficacy and higher pCR than those with positive ER and PR expression after neoadjuvant chemotherapy. The results suggest that ER and PR negative breast cancer cells may be more sensitive to chemotherapy drugs. The reason may be that the expression level of ER and PR is related to the degree of differentiation of breast cancer. The expression of ER and PR in breast cancer indicates that breast cancer cells still retain the characteristics of hormone dependent growth, and the degree of cell differentiation is high, whereas ER and PR negative breast cancer cells malignant degree is high, the proliferation of hyperplasia more exuberant, and therefore more sensitive to chemotherapy drugs that block cell growth and reproduction [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. For survival prognosis, this study found that the level of ER expression had no significant effect on the disease-free survival and overall survival. Breast cancer with negative ER, PR and HER-2 is triple negative breast cancer. According to many studies [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], triple negative breast cancer is more likely to obtain pathological complete remission with neoadjuvant chemotherapy than other types of breast cancer, but it also has a higher risk of metastasis and recurrence. This study found that the pCR rate of neoadjuvant chemotherapy for triple negative breast cancer and Her-2 positive breast cancer was higher than that of Luminal A type breast cancer, but there was no significant difference in survival prognosis between different types of breast cancer. Tulbah et al. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] also believed that Her-2 expression level before neoadjuvant chemotherapy could not be used as an indicator to predict tumor sensitivity to neoadjuvant chemotherapy and prognosis. The reason for this difference may be that there are many factors affecting the efficacy and prognosis of chemotherapy. For example, different chemotherapy regimens and follow-up time can have differences on the results, which needs further large sample long-term follow-up study.\u003c/p\u003e \u003cp\u003eKi67 is a proliferating cell related antigen, which can reflect the proliferative activity of tumor cells. This study showed that breast cancer patients with high Ki67 expression had a higher pCR rate of neoadjuvant chemotherapy and were more sensitive to chemotherapy, and Ki67 was an independent predictor of the efficacy of neoadjuvant chemotherapy. Jain et al. [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] also made similar findings, and believed that Ki67\u0026thinsp;\u0026gt;\u0026thinsp;35% was an independent predictor of pCR in neoadjuvant chemotherapy. Chen et al. [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] considered that the expression level of Ki67 could predict the efficacy of neoadjuvant chemotherapy containing anthracycline through meta-analysis. It should be noted that although the high expression of Ki67 means high sensitivity to chemotherapy, it also indicates high proliferative activity. This study found that breast cancer patients with high expression of Ki67 were more likely to have recurrence and metastasis, and were independent risk factors for recurrence and metastasis of breast cancer. Although the overall survival of breast cancer patients with high Ki67 expression had no significant difference compared with those with low Ki67 expression, their disease-free survival was shorter. Gunter et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] also showed that patients with high Ki67 expression had a higher risk of disease recurrence and death. It can be seen that Ki67 is one of the biological indicators with good research prospects to predict the efficacy of neoadjuvant chemotherapy and disease-free survival.\u003c/p\u003e \u003cp\u003eDifferent neoadjuvant chemotherapy regimens have different effects on chemotherapy efficacy of breast cancer and prognosis. This study evaluated the efficacy and prognosis of commonly used neoadjuvant chemotherapy regimens (AC, EC, ET, TC and FEC) for breast cancer. It was found that there was no significant difference in the efficacy and survival prognosis of these neoadjuvant chemotherapy regimens, but the probability of recurrence or metastasis of breast cancer patients using ET regimen was lower than that of other chemotherapy regimens. The ET regimen may be a protective factor for recurrence or metastasis of breast cancer. The ET regimen includes epirubicin and taxotere. Previous studies [\u003cspan additionalcitationids=\"CR39\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] have also shown that neoadjuvant chemotherapy with taxotere and epirubicin has good curative effect, and the survival prognosis of epirubicin combined with taxotere is better than that of epirubicin alone. In addition to the selection and application of chemotherapy drugs, the dose density and intensity of drug use will also affect the clinical efficacy and prognosis [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Therefore, the role of ET regimen in inhibiting recurrence or metastasis of breast cancer needs to be further refined. In addition, this study also found that patients with no postoperative chemotherapy was related to lower risk of recurrence and metastasis. The possible reason is that we evaluated the postoperative pathology and the efficacy of neoadjuvant chemotherapy, and those patients with worse pathology and efficacy of neoadjuvant chemotherapy received postoperative chemotherapy. In many studies of neoadjuvant chemotherapy, pCR has been regarded as one of the most important quantitative indicators of chemotherapy response, and it is considered to be an early signal to improve the prognosis of patients, and may replace DFS and OS [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. This study found that there was no significant correlation between pCR and recurrence or metastasis of breast cancer and prognosis of patients. pCR may not be a good indicator of survival. As mentioned above, breast cancer patients with high expression of Ki67 are more sensitive to neoadjuvant chemotherapy, and the pCR rate is higher than that of patients with low Ki67 expression. However, the prognosis of patients with high Ki67 expression is often poor. Some previous studies also did not support the use of pCR rates of neoadjuvant chemotherapy as an alternative endpoint for disease-free survival and overall survival [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Therefore, we think that in the same pathological index (such as similar Ki67 expression level) or the same pathological molecular type (such as triple negative breast cancer) or similar invasive breast cancer cells, and so on, the prognosis of breast cancer patients is predicted by pCR.\u003c/p\u003e \u003cp\u003eTo sum up, the efficacy of neoadjuvant chemotherapy and survival prognosis of breast cancer patients are influenced by many indicators, especially the role of T staging, LNR and Ki67 expression. Considering the reactivity of chemotherapy and the prognosis of patients are complex processes which are affected by many factors. Considering that chemotherapeutic response and patient prognosis are complex processes affected by multiple factors, the combination of more indicators, such as molecular biomarkers and multi-gene testing, may be more beneficial to predict results, and at the same time can make the treatment of breast cancer more effective and more targeted. Due to the retrospective study, small sample size, short follow-up time and insufficiently detailed index classification, this study still has some limitations and needs to be further improved in future studies.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eIn conclusion, Our study found that clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy were related to cTNM staging, LNR, ER/PR, and Ki-67.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eT.B. wrote the first draft of this paper, and Z.X. revised this paper. All authors participated in the clinical design.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDeSantis CE, Ma JM, Gaudet MM, Newman LA, Miller KD, Sauer AG, et al. Breast cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69:438-51.\u003c/li\u003e\n\u003cli\u003eLi H, Zheng RS, Zhang SW, Zeng HM, Sun KX, Xia CF, et al. 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Medicine (Baltimore). 2018;97:e11647.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Breast cancer, Neoadjuvant chemotherapy, Pathological complete response, Prognosis","lastPublishedDoi":"10.21203/rs.3.rs-2552365/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2552365/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo investigate predictive indicators of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e290 female patients with breast cancer who treated with neoadjuvant chemotherapy were enrolled in this study. The collected data including tumor position, tumor size, cTNM staging, LNR, pathological molecular types(including ER, PR, Her-2, Ki-67 and so on), neoadjuvant chemotherapy regimens, pathological complete response rate, postoperative treatment and survival time.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNeoadjuvant chemotherapy curative effect was related to pausimenia, T staging, N staging, ER/PR and Ki-67(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), N staging (OR\u0026thinsp;=\u0026thinsp;0.041, 95% CI\u0026thinsp;=\u0026thinsp;0.012\u0026thinsp;~\u0026thinsp;0.134) and Ki-67 (OR\u0026thinsp;=\u0026thinsp;9.340, 95% CI\u0026thinsp;=\u0026thinsp;1.770\u0026thinsp;~\u0026thinsp;49.286) were independent risk factors of pCR. Recurrence of metastases was related to T staging, LNR, Ki-67, ET regimen, postoperative chemotherapy and postoperation radiotherapy(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), T staging (OR\u0026thinsp;=\u0026thinsp;1.731, 95%CI\u0026thinsp;=\u0026thinsp;1.244\u0026thinsp;~\u0026thinsp;2.408), LNR (OR\u0026thinsp;=\u0026thinsp;2.726, 95%CI\u0026thinsp;=\u0026thinsp;1.430\u0026thinsp;~\u0026thinsp;5.197) and Ki-67 (OR\u0026thinsp;=\u0026thinsp;3.107, 95%CI\u0026thinsp;=\u0026thinsp;1.395\u0026thinsp;~\u0026thinsp;6.920) were independent risk factors of recurrence of metastases. Patients with low Ki-67 expression, low LNR, T1 staging and T2 staging and N0/N1/N2 staging had a better prognosis.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eClinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy were related to cTNM staging, LNR, ER/PR and Ki-67.\u003c/p\u003e","manuscriptTitle":"The influence factors of clinical efficacy and prognosis of breast cancer patients treated with neoadjuvant chemotherapy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-02-14 22:06:36","doi":"10.21203/rs.3.rs-2552365/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"14642428-73e7-49ef-80bd-e33e58eb853c","owner":[],"postedDate":"February 14th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-08-07T05:59:20+00:00","versionOfRecord":[],"versionCreatedAt":"2023-02-14 22:06:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2552365","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2552365","identity":"rs-2552365","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}