Clinical significance of subtype classification in metastatic lymph nodes of breast cancer patients undergoing neoadjuvant chemotherapy

Noriko Nemoto, Yukiko Shibahara, Hiroshi Tada, Keiko Uchida, Keely M. McNamara, Monica S.M. Chan, Mika Watanabe, Kentaro Tamaki, Minoru Miyashita, Yasuhiro Miki, Kohsuke Gonda, Takanori Ishida, Noriaki Ohuchi, Hironobu Sasano

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Neoadjuvant chemotherapy has been increasingly utilized in the treatment of breast cancer patients. However, there are no established surrogate markers predicting the response to subsequent adjuvant therapy and clinical outcome of patients. In particular, whether primary or lymph nodes metastasis should be evaluated for these analyses has remained unknown. Therefore, in this study, we first evaluated the differences in biomarkers between primary and metastatic cancer tissues in the patients undergoing neoadjuvant chemotherapy. We then correlated the findings with the clinical outcomes of these patients. Methods: We examined 49 patients receiving neoadjuvant chemotherapy and subsequent surgery with lymph node metastasis. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2) and Ki-67 were all immunohistochemically evaluated in core needle biopsy samples from primary and metastatic tumors following chemotherapy. Results: No statistically significant differences in these markers were detected between the primary tumor and metastatic lymph nodes following therapy, but the Ki-67 labeling index was significantly higher in metastatic lymph nodes than in primary tumor (p = 0.017). The patients associated with luminal A type carcinoma in their lymph nodes following chemotherapy demonstrated significantly better clinical outcomes (disease-free survival: p = 0.0045, overall survival: p = 0.0006) than those who were not. Conclusion: These data indicate that subtype classification following chemotherapy, in the metastatic lymph nodes rather than primary tumor could predict long-term outcomes of patients undergoing neoadjuvant chemotherapy.

Original languageEnglish
Pages (from-to)e174-e183
JournalInternational Journal of Biological Markers
Issue number2
Publication statusPublished - 2015 Apr 1


  • Breast cancer
  • Immunohistochemistry
  • Lymph node metastases
  • Neoadjuvant chemotherapy
  • Pathology
  • Subtype classification


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