ROLE OF RESIDUAL CANCER BURDEN (RCB) IN PREDICTING THE LONG-TERM OUTCOMES OF BREAST CANCER AFTER NEO-ADJUVANT CHEMOTHERAPY FOLLOWED BY SURGERY: AN AMBISPECTIVE STUDY​ aadarsh2022@gmail.com

 

ROLE OF RESIDUAL CANCER BURDEN (RCB) IN PREDICTING THE LONG-TERM OUTCOMES OF BREAST CANCER AFTER NEO-ADJUVANT CHEMOTHERAPY FOLLOWED BY SURGERY: AN AMBISPECTIVE STUDY​

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India

Oral or Poster

As Binary outcome of pCR versus residual disease do not offer distinction among patients of Breast cancer with varied amounts of residual disease burden. Residual Cancer Burden (RCB) scoring provides a standard set of methods to evaluate and quantify the extent of residual disease in the breast and lymph nodes following NACT. It provides a continuous score and is defined under 4 classes from RCB-0 to RCB-3.

Non metastatic primary breast cancer patients , who received NACT between Jan 2016 to Dec 2023 in the Dept of Surgery at AIIMS, New Delhi included . Patient records were collected through e- hospital, BCC, phone calls, Medipreter and e-records of histopathology and were followed up for EFS, DRFS and OS. C-index of RCB and Miller-Payne grading system was calculated with Z-score test.

Total of 530 patients were included in the final analysis. PCR/RCB-0 in 118(36.5%), RCB-1, 16(4.9%), RCB-2, 99(30.6%), RCB-3 in 90(27.9%) patient. 6-year EFS for RCB-0 was 96.6% vs RCB-3(71.1%) with HR of 9.83 (p=0.000, CI, 3.33-29.04). In the whole cohort and all the molecular subtypes, the C-index was higher for RCB, suggesting, the RCB was better than MP grading system in predicting the outcomes in terms of EFS, DRFS and OS with (p=0.04). Across the cohort, presence of LVI and PNI also emerged as significant markers for predicting the EFS and DRFS but not the OS.

The RCB scoring demonstrates superior prognostic accuracy over the MP grading system in predicting EFS, DRFS, and OS.