Browsing Over 391 Presentations
6P - Deep learning radiomics supports perioperative treatment decisions and is associated with LncRNAs in breast cancer: A multicenter study
- Yunfang Yu (Guangzhou, China)
Abstract
Background
Several studies have indicated that magnetic resonance imaging radiomics can predict survival in patients with breast cancer, but the potential biological underpinning remains indistinct. This study aims to develop an interpretable deep-learning-based network for classifying recurrence risk and revealing the potential biological underpinning.
Methods
In this multicenter study, 1,113 nonmetastatic invasive breast cancer patients were included, and were divided into the training cohort (n=698), the validation cohort (n=171), and the testing cohort (n=244). This study included three phases to develop the Radiomic DeepSurv Net (RDeepNet). In phase 1, the RDeepNet was constructed with deep learning radiomic features for recurrence-free survival (RFS) prediction. RNA-sequencing was performed to explore the mechanisms of radiomics. In phase 2, correlation and variance analyses were conducted to examine changes of radiomics in patients after neoadjuvant chemotherapy. The association and quantitative relation of radiomics and epigenetic molecular characteristics were further analyzed in phase 3.
Results
The RDeepNet was significantly associated with RFS (HR 0.03, 95% CI 0.02–0.06, P < 0.001), and it achieved AUCs of 0.98, 0.94, and 0.92 for 1-, 2-, 3-year RFS. The RDeepNet showed AUCs of 0.91 and 0.94 for 3-year RFS in the validation and testing cohorts, respectively. The RDeepNet was generalized by validation in different molecular subtypes and patients with different therapy regimens (All P < 0.001). The radiomic features were found to vary among patients with different therapeutic responses and after neoadjuvant chemotherapy. Moreover, long non-coding RNAs (lncRNAs) were discovered to be significantly correlated with radiomics and could be quantified by radiomics.
Conclusions
The findings indicate that the RDeepNet can be conveniently used to guide treatment decisions and predict lncRNA expression noninvasively in breast cancer.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
7P - Predicting lymph node metastasis and molecular subtype from pathology united with genomics in breast cancer with multitask deep learning
- Zehua Wang (Hong Kong, Hong Kong PRC)
Abstract
Background
In early-stage of breast cancer, the analysis of lymph node metastasis(LNM) and molecular subtypes is conductive to clinical diagnosis and treatment decision-making. Here we proposed a new Deep learning network architecture, called DeepCALM, Conducted with Attention mechanism to united genomics and pathology, that can simultaneously predict LNM and Molecular subtypes.
Methods
In this retrospective study, DeepCALM was designed to analyse the breast cancer subtype and the degree of metastasis, which include the feature extraction from the digital pathological whold-slide images(WSIs), feature fusion between the feature of WSIs and RNA expression matrix, and muti-task classification. The WSIs and RNA expression data are all from The Cancer Genome Atlas(TCGA), and involved 916 breast cancer patients (2536 WSIs) that were split into training cohort of 734 patients (2021 WSIs) and validation cohort of 182 patients (515 WSIs), and the 219 survival-related gene that screened with the Random forest algorithm from training cohort. Model performances were evaluated using area under the curve (AUC), sensitivity, and specificity.
Results
DeepCALM achieved favourable accuracy for the classification of LNM(macro-average AUC of 0.977, sensitivity of 0.647, specificity of 0.953) and molecular subtypes(macro-average AUC of 0.960, sensitivity of 0.628, specificity of 0.941) in the training cohort, and LNM(AUC of 0.986, sensitivity of 0.647, specificity of 0.953) and molecular subtypes(AUC of 0.955, sensitivity of 0.628, specificity of 0.941) in the validation cohort (all p < 0.001).
Conclusions
The difference between LNM and molecular subtypes of breast cancer can be precisely distinguished by DeepCALM, which helps clinicians effectively determine the stage of tumor diffusion and speed up the diagnosis and accuracy, and then offer treatment or surgery plans.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
8P - Dismantling the role of liquid biopsy in predicting outcome of patients with early-stage breast cancer following neoadjuvant therapy: A systematic review
- Jeremiah H. Wijaya (Tangerang, Indonesia)
Abstract
Background
Numerous studies have suggested that the dynamics of ctDNA during neoadjuvant therapy in early breast cancer have consequences for prognosis. Still, each study's small number of participants prevents drawing firm conclusions. We aimed to determine the predictive value of liquid biopsy in predicting the outcome of patients with early-stage breast cancer following neoadjuvant therapy.
Methods
Each author searched PubMed, EMBASE, and EuroPMC databases from inception until 5 June 2022. We conducted this study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The eligible studies must have the following inclusion criteria: Early-stage breast cancer patients receiving neoadjuvant systemic therapy of any kind, an observational study (prospective or retrospective), or randomized control trials, and have documented serial collection of ctDNA and outcome data of interest. The impact of ctDNA detection at several time intervals on relapse-free survival and overall survival was the primary key outcome of the current study. In terms of data extraction, we collected the following from eligible studies: author, year of publication, number of patients, method of ctDNA analysis, RFS, and OS. We applied the Cochrane Collaboration's Risk of Bias tool to thoroughly evaluate the risk of bias in all qualifying publications.
Results
11 were counted in the meta-analysis since they satisfied the qualifying requirements. ctDNA detection significantly decreased both RFS (HR of 4.21 [1.29, 13.81] and 5.90 [2.86, 12.15], respectively) and OS (HR 19.13 [6.90, 53.03] and HR 4.00 [1.90, 8.41], respectively), both at baseline and after the end of neoadjuvant therapy. 8 and 3 studies were good and moderate in quality, respectively.
Conclusions
Our meta-analysis showed that long-term outcomes in early breast cancer were associated with the presence of ctDNA at baseline and after neoadjuvant therapy. Harmonization of methodologies is crucial in forging ahead as it is currently unknown how the analysis method affects the prognostic importance of ctDNA. Further studies need to be conducted in the near future with a standardized analysis method of ctDNA.
Legal entity responsible for the study
Jeremiah Hilkiah Wijaya.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
9P - Development and validation of a pathogenomics model to improve the risk stratification of breast cancer: A deep learning study
- Lin Ruichong (Hong Kong, China)
Abstract
Background
The risk evaluation of Disease-free survival (DFS) is peculiarly challenging in breast cancer. In this study, we use the combination data of digital pathology, survival-related gene expression, and deep learning (DL) for the ranked prediction risk of DFS in breast cancer. In this process, in order to better predict the risk of disease-free survival after breast cancer, we combined DeepSurv model, ResNet50 model, and Attention-gate mechanism to propose a new deep learning model ROAD according to the structural characteristics of the data.
Methods
In this study, 925 invasive breast cancer patients from TCGA were included and were divided into the training cohort (n=741) and the validation cohort (n=184). This study included three phases to develop the DL model. In phase 1, according to the random forest algorithm, a high survival-related gene will be chosen, and then the DeepSurv model was constructed with deep learning survival-related gene features for DFS prediction. In phase 2, digital pathology features can be extracted by pre-trained ResNet50, and then the attention-gate is used to screen the features for DFS prediction. We design specific access from the above DL network by adding the gene information to the end of the attention-gate, which can be seen as the input of the DeepSurv, that can combine pathology with genomics to predict Disease-free survival risk degree after breast cancer surgery was further analyzed in phase 3.
Results
The deep learning model was significantly associated with DFS (P < 0.001), and it achieved C-index of 0.968(±0.003) on the training dataset. And the model showed significant improvement the C-index from 0.891 to 0.965(±0.04) for DFS in the testing cohort by comparing the gene expression matrix and pathology features with the combination.
Conclusions
The ROAD model can achieve an accurate risk evaluation of breast cancer patients and can be conveniently used to guide treatment decisions and predict DFS in breast cancer.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
10P - Enriched gut microbiota increases anticancer drug efficacy in breast cancer cell lines: A promising in vitro approach
- Selvaraj Jayaraman (Poonamallee, India)
Abstract
Background
Breast cancer is the most common and leading cause of cancer-related deaths in women. Recently, the gut-microbiome's dysbiosis has been noticed to impact on breast cancer and its management.Due to the adaptability of the variety of microbes and chemotherapeutic drugs used to treat breast cancer, mechanistic information is essential, yet these models are tedious and challenging to manage.
Methods
We have developed a unique setup to examine the relationship between gut microbiota and anticancer medications with breast cancer cell lines using IdMOC. The outside well contained MCF-7 and MDA-MB-231, and inner well contained a culture-enriched microbiome (CEM) obtained from pooled human faeces. Our designed setup allows free interaction of bacterial metabolites with the cell lines. Chemotherapeutic drugs like doxorubicin, paclitaxel, and carboplatin were added to the cells with variable concentrations of CEM from 100 to 1000 CFU at the inner well of the setup. Expression of Bcl-2, Bax and caspases-3, ras (oncogen), and MEK were measured in MCF-7 and MDA-MB-231 by quantitative PCR.
Results
Our research revealed that the response to anticancer drugs was in the following order: Doxorubicin > Paclitaxel > Carboplatin. These substances increased Bax and caspase-3 while down regulating the anti-apoptotic genes ras, MEK, and Bcl-2. It's interesting to note that these chemotherapeutic drugs had superior anticancer efficacy when they had a high titer of microbiome at least 1000 CFU. Particularly, when MCF-7 and MDA-MB-231 cells were grown with 1000 CFU of CEM instead of 100 CFU, Doxorubicin was 56% more effective at causing apoptosis, Paclitaxel was 40% more effective, and Carboplatin was 27% more effective.
Conclusions
We offer a novel method to evaluate the impact of anticancer medications while accounting for the function of gut bacteria. In this approach, traditional breast cancer cell lines are co-cultured with enriched microbiomes. According to the results of the current study, maintaining the natural microbiota improves the efficiency of cancer chemotherapy drugs. The microbiome should therefore be taken into consideration as a key factor for determining the pharmacology of anti-cancer medications.
Legal entity responsible for the study
Raktim Mukherjee, Vishnu Priya Veeraraghavan, Megha Dave, Selvaraj Jayaraman, A. Thirumal Raj, Shankargouda Patil.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
11P - Preservation of intercostobrachial nerve during axillary lymph node dissection in breast cancer patients positively impacts chronic pain, sensory changes, and quality of life: Should it be the standard?
- Ajai Sasidhar (New Delhi, India)
Abstract
Background
Breast cancer survivors suffer from various survivorship issues, including persistent pain, sensory changes, and poor quality of life, often overlooked in traditional mortality and morbidity indicators. The study's objective was to determine whether intercostobrachial nerve (ICBN) preservation resulted in reduced chronic pain, sensory changes, and improved quality of life in breast cancer survivors.
Methods
A prospective observational study was conducted between 2018 and 2020 among 81 breast cancer patients undergoing axillary lymph node dissection and was divided into two cohorts based on the ICBN preservation or division. The patients were interviewed at 6 months with EORTC QoL Questionnaire.
Results
ICBN preserved group had statistically significant less frequent sensory changes at discharge 51.5% vs. 87.5% (p=<0.001) which improved at six months 27.3% vs. 72.7% (p=<0.001). Clinically significant pain was reduced in the ICBN preservation group 15.2% vs. 84.8% (p=<0.001). Similarly, it had significantly better scores in physical, emotional functioning domains in EORTC QoL and fewer scores in symptom scales of pain and fatigue.
Conclusions
Our study shows that preservation of the intercostobrachial nerve is associated with significantly reduced pain in the chest wall, axilla, arm, lesser sensory changes, and improved quality of life. ICBN preservation should be considered in all patients undergoing axillary dissection for breast cancer.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
12P - Non-clinical factors influencing patient’s choice of mastectomy over breast conservation among Indian women with breast cancer
- Nivedita Sharma (Jodhpur, India)
Abstract
Background
Despite enough evidence supporting equal outcomes of Breast Conservation Therapy (BCT) and Modified Radical Mastectomy (MRM) in early breast, rates of mastectomy are still high in most of the regions of India barring few metro cities. Other than clinical parameters and availability of resources, several other sociodemographic factors and personal beliefs play a very vital role in decision making about type of surgery by Indian patients. This study aimed to investigate the factors which influenced the surgical choice in patients eligible for BCS.
Methods
Of 316 women who underwent surgery for Ca Breast in our department between Jan 2020 -Dec 2021, 119 were found to be eligible for BCS. A questionnaire containing details of various sociodemographic factors, individual beliefs and role of others in decision making was filled by patients. Univariate analysis was employed to determine the factors associated with the different surgical choices.
Results
Among 119 patients eligible for BCS; 12 patients were excluded for lack of consent or contact. Of 107 patients, 25 chose BCS and 82 chose MRM. On analysis of various socio-demographic factors, education above primary school, higher income, and urban residence was found to be significantly associated (P<0.02, P<0.03, P<0.02 respectively) with choice of BCS. Patients who received NACT or had family history of any malignancy were more inclined towards MRM, though the difference did not reach statistical significance. Among patients who chose MRM, about 2/3 feared about cancer recurrence or possibility of tumour being left behind with more conservative surgery while only 5% took this decision to avoid radiotherapy. Patient’s desire to hide their disease and surgery status as well as surgeons reassurance of equivalent survival were the driving factors among patients who chose BCS.
Conclusions
Decision making for type of surgery among breast cancer patients is complicated & governed by fears, social pressures, financial concerns & cosmetic expectations, which are slightly different among Indian women as compared to the western world. A better understanding of these may help increase the rate of BCS in rural and suburban population of India.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
13P - Hypofractionated radiotherapy in post operative breast cancer patients: 3-year clinical experience in a newly established cancer center
- Shaila Sharmin (Dhaka, Bangladesh)
Abstract
Background
Breast conserving surgery and post mastectomy breast irradiation has been established as a standard care for early breast cancer. RT dose of 45-50 Gy in 1.8-2 Gy per fraction & 42.5 Gy at 2.66 Gy per fraction. Tumor bed boost is recommended in patients at higher risk for local failure, age < 50 years, positive axillary nodes, LVSI, or close margins. Typical doses are 10-16 Gy at 2 Gy per fraction. All dose schedules are given 5 days per week. Post mastectomy regional radiotherapy (PMRT) is effective at preventing locoregional failure (LRF).
Methods
All patients were staged accordingly. Data collection would be in tabulated sheet. This retrospective chort study conducted in cancer center, CMH, Dhaka, Bangladesh, including patients with carcinoma of breast treated with hypofractionated radiotherapy during last 03 year. The patient treated with 3DCRT, IMRT by LINAC, 6 MV photon and appropriate electron energy.
Results
Out of 82 patients,12 had undergone BCS and 70 mastectomy. Mean age of population was 52 years. 80% were T1&T2 in BCS group whereas most patients in mastectomy group had T3&T4 (60%). 45% were node negative in BCS group. TNBC accounted for 13% and their mean age was 43 yrs. Acute skin toxicity at the end of treatment was Grade 1 in 94% of mastectomy group and 71% in BCS group. Grade 2 toxicity was 6% in mastectomy group and 23% in BCS group. Grade 3 was 6% in BCS group. No grade 3 toxicity in mastectomy patients and grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had Grade I skin reaction which was only 7% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. 3% of BCS and 8% of mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mastectomy had developed metastatic disease at the time of evaluation.
Conclusions
Hypofractionated RT is well tolerated with less acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centre to increase machine output time. The study is on-going to assess long term results.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
14P - The impact of the deep inspiration breath-hold (DIBH) technique in the heart and other organ-at-risk (OAR) dose sparing in the postoperative radiotherapy to the left early breast cancer
- Hui-Ling Yeh (Taichung City, TW, Taiwan)
Abstract
Background
Under the deep inspiration breath hold (DIBH) technique a considerable volume of the heart can be reduced to the high radiation doses. To investigate whether implementing DIBH to the hybrid technique will further reduce the cardiac doses, we compared the dosimetry characteristics of hybrid and VMAT treatment planning under DIBH and free breath.
Methods
Twenty patients with left-sided breast cancer who underwent breast-conserving surgery were selected for this study. Two sets of CT images were already acquired under deep-inspiration breath-hold (DIBH) and free-breathing(FB) before treatment. The same contours based on the original DIBH CT data sets were used for the modified Hybrid-technique and VMAT technique re-planning for the comparison of the original Hybrid planning. All plans were optimized to cover 100% of the PTV by 95% of the prescribed dose while minimizing the doses to the OAR as much as possible. The dosimetric differences among the 3 treatment plans for the 20 patients were analyzed using the Wilcoxon signed-rank test, the p value<0.05 were considered statistically significant. All analyses were performed using SPSS software, version 19.0.
Results
The mean heart dose was reduced from 3.2Gy and 5.38Gy, respectively (p value=0.002) and the LAD0.03cc dose was reduced from 14.85Gy and 24.91Gy, respectively (p value=0.001) by modified Hybrid-technique on DIBH and FB conditions. No statistically significant dose difference (p value>0.05) was found in the tumor conformity and homogeneity, and the critical organ on the affected side by the modified Hybrid-technique of VMAT under DIBH. In the contralateral critical organ, the modified Hybrid-tech showed better dose sparing than VMAT on the average dose of the contralateral lung, and the average dose of the contralateral breast.
Conclusions
Modified Hybrid-technique provides the best benefits for heart and OAR radiation dose sparing effect on DIBH condition.
Clinical trial identification
This clinical trial is approved by the institution review board of Taichung Veterans General Hospital (CE21447B).
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
15P - Delays in breast cancer treatment in a tertiary hospital
- Rogelio N. Velasco (Manila, Philippines)
Abstract
Background
The burden of treatment delay in breast cancer is high, especially among developing countries. Despite adversely affecting morbidity and mortality, this burden still remains largely unexplored. This study aimed to determine treatment delays among breast cancer patients in a tertiary hospital during surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy and to identify predictors of delay.
Methods
A retrospective cohort study was conducted among breast cancer patients seen between January 1, 2012 to December 31, 2018. The following outcomes were investigated: delay in neoadjuvant chemotherapy, delay in surgery, delay in adjuvant chemotherapy, and any form of delay. Summary statistics were reported as percent for categorical data and as mean for continuous data. The individual correlations were performed using Chi-square for qualitative data and t-test for quantitative data while predictors were determined through logistic regression.
Results
A total of 324 patients were included in this study. The majority of the patients were less than 65 years old living in rural areas. More than half of the patients were overweight or obese, hypertensive, and diabetic. A high prevalence of delays were observed: 61.1% (n = 198) with any type of delay, 23.8% (n = 53) with delay in surgery, 53.8% (n = 120) with delay in adjuvant chemotherapy, and 74.3% (n = 75) with delay in neoadjuvant chemotherapy. Patients from rural areas and those with hypertension were associated with any form of delay. The presence of coronary artery disease andN2 disease were associated with delay in surgery. The use of doxorubicin, cyclophosphamide, and docetaxel and the docetaxel-cyclophosphamide doublet regimens were both associated with delay in adjuvant chemotherapy. Moreover, T2-T3, N2-N3, and grade 1-2tumors, and the use of the doublet doxorubicin-cyclophosphamide with or without subsequent docetaxel were also associated with any form of delay.
Conclusions
The present study shows a high prevalence of treatment delay among breast cancer patients. Further studies may be done to identify factors affecting these delays and policy changes are recommended to address these gaps in treatment.
Legal entity responsible for the study
Rogelio Velasco Jr.
Funding
Philippine General Hospital - Expanded Hospital Research Office.
Disclosure
All authors have declared no conflicts of interest.
16P - The prognostic value of androgen receptor expression in triple-negative breast cancer patients
- Rasha M. Haggag (Zagazig, ElSharkia, Egypt)
Abstract
Background
Triple negative breast cancer (TNBC) is a distinct subtype of BC that is characterized by frequent recurrence and metastasis. Patients with TNBC have significantly worse prognosis compared to other subtypes of BC due to lack of well-defined targeted and endocrinal therapy. Androgen receptor (AR) expression is an emerging prognostic marker that has been observed in 10% to 50% of TNBC.The aim was to assess the relation between AR and clinicopathological features. Also, assessing the survival outcome in relation to AR expression in TNBC patients.
Methods
This is a clinicopathological and immunohistochemical retrospective study included 35 patients with non-metastatic TNBC treated at Medical Oncology Department, Maadi Armed Forces Medical complex from January 2015 to June 2019.
Results
The age of patients ranged from 29 to 72 years and the median age was 57 years, most of them were postmenopausal (80%), obese patients represent 65.7 %, while the predominant histologic subtype was IDC (91.4%) with relatively high-grade tumors (G3; 60%), TNBC patients had relatively large tumors T2 (60%) and T3 (31.4%), high Ki-67 ≥20% (74.3%).AR was positive in (13/35; 37%) which was significantly related to tumor grade (P=0.04) and proliferative index Ki-67 (P=0.009).The median DFS in patients with low Ki-67 was 23 months (P=0.01) and for AR-positive patients was 14 months while those with AR-negative was 12 months (P=0.09). The median OS in AR-positive patients was 26 months while, those with AR-negative the median OS was 20 months (P=0.03).
Conclusions
TNBC is aggressive disease with mixed heterogenicity associated with poor prognostic outcome.AR positivity was associated with lower risk of disease recurrence, mortality and improved overall survival.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
17P - Clinical, pathological complete response and prognosis characteristics of HER2-low breast cancer in neoadjuvant chemotherapy setting: A retrospective analysis
- Hui Liu (Zhengzhou, China)
Abstract
Background
With the emergence of novel antibody-drug conjugates (ADC) drugs, HER2 low breast cancer may become a new clinical therapeutic subtype. The present study was conducted to evaluate the clinical, pathological complete response (pCR) and prognosis characteristics of HER2-low breast cancer in neoadjuvant chemotherapy setting.
Methods
Patients with HER2 negative breast cancer who have received neoadjuvant chemotherapy from January 2017 to December 2019 were retrospectively analyzed in a single center. HER2 negative breast cancer was divided into two groups: HER2-zero and HER2-low. HER2-zero was defined as IHC 0, and HER2-low was defined as IHC 1+ or IHC 2+/fluorescence in-situ hybridization (FISH) negative. The primary end point was pCR, secondary end points included disease free survival (DFS) and overall survival (OS).
Results
314 patients with HER2 negative breast cancer were enrolled. The proportion of HER2-low was 75.3% in HR-positive disease and 63.2% in triple-negative breast cancer (TNBC). In HR-positive breast cancer, HER2-low tumors presented less nodal involvement (p = 0.023) and earlier clinical stage (p = 0.015) compared to HER2-zero tumors. However, in TNBC, patients with HER2-low have a later clinical stage (p = 0.028). With the pCR defined as ypTis/0ypN0, there was no difference in pCR rates among general population, HR-positive disease and TNBC. However, with the pCR defined as ypT0ypN0, the pCR rate in HER2-low breast cancer was significantly lower than HER2-zero breast cancer in the general population (24.3% vs. 36.4%, P=0.032) and HR-positive subgroup (18.7% vs. 32.1%, P=0.035), but not for TNBC. Univariate and multivariate analysis demonstrated that HER2 status (low vs. zero) was an independent predictive factor for pCR (P = 0.013) in HR-positive breast cancer. There were no statistically significant differences in 3-year DFS and OS between HER2-low and HER2-zero breast cancer among general population, HR-positive disease and TNBC.
Conclusions
HER2-low breast cancer exhibit specific clinical features and different response to treatment associated with HR status in neoadjuvant chemotherapy setting.
Legal entity responsible for the study
The authors.
Funding
Medical Science and Technique Foundation of Henan Province.
Disclosure
All authors have declared no conflicts of interest.