The experience of preoperative treatment with anthracyclines in patients with luminal-type B locally advanced breast cancer




breast cancer, luminal В, doxorubicin, cyclophosphamide, chemotherapy


Aim. To determine the effectiveness of preoperative treatment of luminal-type B locally advanced breast cancer in patients with the use of Doxorubicin + Cyclophosphamide chemotherapy regimen.

Materials and methods. Thirty patients with luminal-type B locally advanced breast cancer who underwent chemotherapy with Doxorubicin 60 mg/m2 + Cyclophosphamide 600 mg/m2 regimen were examined at the medical center LLC “ONCOLIFE” from 2019 to 2020. Results of chemotherapy were assessed by CT scan examination and RECIST1.1 system with further surgical treatment of breast cancer. The results of pathomorphological response to treatment of tumor were assessed by the Miller–Payne system.

Results. Before the surgery, clinical complete response to chemotherapy was achieved in 9 (30.0 %) patients, and complete pathomorphological response to the treatment of tumor was achieved in 7 (21.0 %) patients out of 30. Clinically, the minimal response to treatment (stabilization of the disease) was revealed in 4 (13.4 %) patients, minimal pathomorphological response – in 9 (32.4 %) patients.

Conclusions. The method of selecting a chemotherapeutic regimen based on chemoresistance factor data could potentially improve the effectiveness of preoperative therapy and survival in the future that requires more detailed study.

Author Biographies

D. Ye. Cherniavskyi, Zaporizhzhia State Medical University, Ukraine

MD, PhD student of the Department of Oncology and Surgical Oncology

O. P. Kolesnik, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Oncology and Surgical Oncology


Syvak, L. A., Veriovkina, N. O., & Lyalkin, S. A. (2014). Prohnostychni faktory pry raku hrudnoi zalozy. Suchasnyi stan problemy [Breast cancer prognostic factors. Current state of the problem]. Klinichna onkolohiia, (4), 46-48. [in Ukrainian].

Fedorenko, Z. P., Hulak, L. O., Mykhailovych, Yu. Y., Horokh, Ye. L., Ryzhov, A. Yu., Sumkina, O. V., & Kutsenko, L. B. (2021). Cancer in Ukraine, 2019-2020. Incidence, mortality, prevalence and other relevant statistics. Bulletin of the National Cancer Registry of Ukraine, 22. [in Ukrainian].

World Health Organization. (2021, March 26). Breast cancer. World Health Organization Statistic.

Gonzalez-Angulo, A. M., Morales-Vasquez, F., & Hortobagyi, G. N. (2007). Overview of resistance to systemic therapy in patients with breast cancer. Advances in experimental medicine and biology, 608, 1-22.

Morra, A., Jung, A. Y., Behrens, S., Keeman, R., Ahearn, T. U., Anton-Culver, H., Arndt, V., Augustinsson, A., Auvinen, P. K., Beane Freeman, L. E., Becher, H., Beckmann, M. W., Blomqvist, C., Bojesen, S. E., Bolla, M. K., Brenner, H., Briceno, I., Brucker, S. Y., Camp, N. J., Campa, D., … NBCS Collaborators (2021). Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium. Cancer epidemiology, biomarkers & prevention, 30(4), 623-642.

Abubakar, M., Figueroa, J., Ali, H. R., Blows, F., Lissowska, J., Caldas, C., Easton, D. F., Sherman, M. E., Garcia-Closas, M., Dowsett, M., & Pharoah, P. D. (2019). Combined quantitative measures of ER, PR, HER2, and KI67 provide more prognostic information than categorical combinations in luminal breast cancer. Modern pathology, 32(9), 1244-1256.

Li, Z. H., Hu, P. H., Tu, J. H., & Yu, N. S. (2016). Luminal B breast cancer: patterns of recurrence and clinical outcome. Oncotarget, 7(40), 65024-65033.

Fragomeni, S. M., Sciallis, A., & Jeruss, J. S. (2018). Molecular Subtypes and Local-Regional Control of Breast Cancer. Surgical oncology clinics of North America, 27(1), 95-120.

National Comprehensive Cancer Network. (2021, December 20). NCCN Clinical Practice Guideines in Oncology. Breast cancer version 4.2022.

Cardoso, F., Kyriakides, S., Ohno, S., Penault-Llorca, F., Poortmans, P., Rubio, I. T., Zackrisson, S., Senkus, E., & ESMO Guidelines Committee (2019). Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology, 30(10), 1674.

Gandhi, S., Brackstone, M., Hong, N., Grenier, D., Donovan, E., Lu, F. I., Skarpathiotakis, M., Lee, J., Boileau, J. F., Perera, F., Simmons, C., Joy, A. A., Tran, W. T., & Canadian National Neoadjuvant Breast Cancer Consortium (2022). A Canadian national guideline on the neoadjuvant treatment of invasive breast cancer, including patient assessment, systemic therapy, and local management principles. Breast cancer research and treatment, 193(1), 1-20.

Shimoi, T., Nagai, S. E., Yoshinami, T., Takahashi, M., Arioka, H., Ishihara, M., Kikawa, Y., Koizumi, K., Kondo, N., Sagara, Y., Takada, M., Takano, T., Tsurutani, J., Naito, Y., Nakamura, R., Hattori, M., Hara, F., Hayashi, N., Mizuno, T., Miyashita, M., … Toyama, T. (2020). The Japanese Breast Cancer Society Clinical Practice Guidelines for systemic treatment of breast cancer, 2018 edition. Breast cancer, 27(3), 322-331.

Eisenhauer, E. A., Therasse, P., Bogaerts, J., Schwartz, L. H., Sargent, D., Ford, R., Dancey, J., Arbuck, S., Gwyther, S., Mooney, M., Rubinstein, L., Shankar, L., Dodd, L., Kaplan, R., Lacombe, D., & Verweij, J. (2009). New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). European journal of cancer, 45(2), 228-247.

Ogston, K. N., Miller, I., Payne, S., Hutcheon, A. W., Sarkar, T. K., & Heys, S. D. (2001). A novel grading system to assess pathological response and predict survival in patients receiving primary chemotherapy for breast cancer. European Journal of Cancer, 37, 27.

Shien, T., & Iwata, H. (2020). Adjuvant and neoadjuvant therapy for breast cancer. Japanese Journal Of Clinical Oncology, 50(3), 225-229.

Potter, D. A., Herrera-Ponzanelli, C. A., Hinojosa, D., Castillo, R., Hernandez-Cruz, I., Arrieta, V. A., Franklin, M. J., & Yee, D. (2021). Recent advances in neoadjuvant therapy for breast cancer. Faculty reviews, 10, 2.

Hyder, T., Bhattacharya, S., Gade, K., Nasrazadani, A., & Brufsky, A. M. (2021). Approaching Neoadjuvant Therapy in the Management of Early-Stage Breast Cancer. Breast cancer, 13, 199-211.

Fisher, B., Brown, A., Mamounas, E., Wieand, S., Robidoux, A., Margolese, R. G., Cruz, A. B., Jr, Fisher, E. R., Wickerham, D. L., Wolmark, N., DeCillis, A., Hoehn, J. L., Lees, A. W., & Dimitrov, N. V. (1997). Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. Journal of clinical oncology, 15(7), 2483-2493.

Center for Drug Evaluation and Research. (2020, July). Pathological Complete Response in Neoadjuvant Treatment of High-Risk Early-Stage Breast Cancer: Use as an Endpoint to Support Accelerated Approval. Retrieved from:

Samiei, S., Simons, J. M., Engelen, S., Beets-Tan, R., Classe, J. M., Smidt, M. L., & EUBREAST Group (2021). Axillary Pathologic Complete Response After Neoadjuvant Systemic Therapy by Breast Cancer Subtype in Patients With Initially Clinically Node-Positive Disease: A Systematic Review and Meta-analysis. JAMA surgery, 156(6), e210891.

Spring, L. M., Fell, G., Arfe, A., Sharma, C., Greenup, R., Reynolds, K. L., Smith, B. L., Alexander, B., Moy, B., Isakoff, S. J., Parmigiani, G., Trippa, L., & Bardia, A. (2020). Pathologic Complete Response after Neoadjuvant Chemotherapy and Impact on Breast Cancer Recurrence and Survival: A Comprehensive Meta-analysis. Clinical cancer research, 26(12), 2838-2848.

Cao, L., Sugumar, K., Keller, E., Li, P., Rock, L., Simpson, A., Freyvogel, M., Montero, A. J., Shenk, R., & Miller, M. E. (2021). Neoadjuvant Endocrine Therapy as an Alternative to Neoadjuvant Chemotherapy Among Hormone Receptor-Positive Breast Cancer Patients: Pathologic and Surgical Outcomes. Annals of surgical oncology, 28(10), 5730-5741.

Bear, H. D., Anderson, S., Brown, A., Smith, R., Mamounas, E. P., Fisher, B., Margolese, R., Theoret, H., Soran, A., Wickerham, D. L., Wolmark, N., & National Surgical Adjuvant Breast and Bowel Project Protocol B-27 (2003). The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. Journal of clinical oncology, 21(22), 4165-4174.

Von Minckwitz, G., Untch, M., Blohmer, J. U., Costa, S. D., Eidtmann, H., Fasching, P. A., Gerber, B., Eiermann, W., Hilfrich, J., Huober, J., Jackisch, C., Kaufmann, M., Konecny, G. E., Denkert, C., Nekljudova, V., Mehta, K., & Loibl, S. (2012). Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. Journal of clinical oncology, 30(15), 1796-1804.

Bines, J., Small, I. A., Sarmento, R., Kestelman, F., Silva, S., Rodrigues, F. R., Faroni, L., Gonçalves, A., Ebecken, E., Maroun, P., Millen, E., & Bonamino, M. (2020). Does the Sequence of Anthracycline and Taxane Matter? The NeoSAMBA Trial. The oncologist, 25(9), 758-764.

Von Minckwitz, G., Raab, G., Caputo, A., Schütte, M., Hilfrich, J., Blohmer, J. U., Gerber, B., Costa, S. D., Merkle, E., Eidtmann, H., Lampe, D., Jackisch, C., du Bois, A., & Kaufmann, M. (2005). Doxorubicin with cyclophosphamide followed by docetaxel every 21 days compared with doxorubicin and docetaxel every 14 days as preoperative treatment in operable breast cancer: the GEPARDUO study of the German Breast Group. Journal of clinical oncology, 23(12), 2676-2685.

Wu, W., Chen, J., Deng, H., Jin, L., He, Z., Rao, N., Nie, Y., Yao, Y., Yang, Y., Su, F., & Liu, J. (2021). Neoadjuvant everolimus plus letrozole versus fluorouracil, epirubicin and cyclophosphamide for ER-positive, HER2-negative breast cancer: a randomized pilot trial. BMC cancer, 21(1), 862.



How to Cite

Cherniavskyi DY, Kolesnik OP. The experience of preoperative treatment with anthracyclines in patients with luminal-type B locally advanced breast cancer. Zaporozhye medical journal [Internet]. 2022Sep.6 [cited 2024Feb.24];24(4):420-4. Available from:



Original research