Purpose: In breast cancer, a pathological complete response (pCR) has been described as generally resulting in a favorable prognosis. However, there are subgroups, such as patients with a mutation in BRCA1 or BRCA2,in which the effect of pCR on the prognosis is suspected to be weaker. Patients with a family history of breast and/or ovarian cancer may therefore react differently in relation to pCR and prognosis, and this is investigated in this study. Patients and Methods: Breast cancer patients were identified from a clinical breast cancer registry. The study subjects had been treated with neoadjuvant chemotherapy from 2001 to 2018 and their pathological and clinical information as well as medical family history were available. They were considered to have a positive family history if they had at least 1 first-degree relative with breast and/or ovarian cancer. Multivariate logistic regression analyses were performed to study the association between family history, pCR (ypT0; ypN0), and disease-free survival (DFS). Results: Of 1,480 patients, 228 (15.4%) had a positive family history. The pCR rates were 24.9% in all patients, and 24.4% and 27.6% in those without/with a family history, respectively. Family history was not associated with a higher pCR rate (adjusted odds ratio [OR] 1.23; 95% confidence interval [CI] 0.85–1.76; p = 0.27) or a different disease-free survival (DFS; adjusted hazard ratio [HR] 1.15; 95% CI 0.88–1.52; p = 0.30). pCR did not affect the prognosis differently in relation to family history. Conclusions: In this retrospective analysis, family history was not associated with pCR and DFS. pCR improved survival, independently of family history.

1.
Taran
FA
,
Schneeweiss
A
,
Lux
MP
,
Janni
W
,
Hartkopf
AD
,
Nabieva
N
, et al.
Update Breast Cancer 2018 (Part 1) - Primary Breast Cancer and Biomarkers
.
Geburtshilfe Frauenheilkd
.
2018
Mar
;
78
(
3
):
237
45
.
[PubMed]
0016-5751
2.
Hartkopf
AD
,
Müller
V
,
Wöckel
A
,
Lux
MP
,
Janni
W
,
Nabieva
N
, et al.
Update Breast Cancer 2019 Part 1 - Implementation of Study Results of Novel Study Designs in Clinical Practice in Patients with Early Breast Cancer
.
Geburtshilfe Frauenheilkd
.
2019
Mar
;
79
(
3
):
256
67
.
[PubMed]
0016-5751
3.
Fasching
PA
,
Heusinger
K
,
Haeberle
L
,
Niklos
M
,
Hein
A
,
Bayer
CM
, et al.
Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment
.
BMC Cancer
.
2011
Nov
;
11
(
1
):
486
.
[PubMed]
1471-2407
4.
Litton
JK
,
Gonzalez-Angulo
AM
,
Warneke
CL
,
Buzdar
AU
,
Kau
SW
,
Bondy
M
, et al.
Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer
.
J Clin Oncol
.
2008
Sep
;
26
(
25
):
4072
7
.
[PubMed]
0732-183X
5.
von Minckwitz
G
,
Untch
M
,
Nüesch
E
,
Loibl
S
,
Kaufmann
M
,
Kümmel
S
, et al.
Impact of treatment characteristics on response of different breast cancer phenotypes: pooled analysis of the German neo-adjuvant chemotherapy trials
.
Breast Cancer Res Treat
.
2011
Jan
;
125
(
1
):
145
56
.
[PubMed]
0167-6806
6.
Kolberg
HC
,
Schneeweiss
A
,
Fehm
TN
,
Wöckel
A
,
Huober
J
,
Pontones
C
, et al.
Update Breast Cancer 2019 Part 3 - Current Developments in Early Breast Cancer: Review and Critical Assessment by an International Expert Panel
.
Geburtshilfe Frauenheilkd
.
2019
May
;
79
(
5
):
470
82
.
[PubMed]
0016-5751
7.
Paluch-Shimon
S
,
Friedman
E
,
Berger
R
,
Papa
M
,
Dadiani
M
,
Friedman
N
, et al.
Neo-adjuvant doxorubicin and cyclophosphamide followed by paclitaxel in triple-negative breast cancer among BRCA1 mutation carriers and non-carriers
.
Breast Cancer Res Treat
.
2016
May
;
157
(
1
):
157
65
.
[PubMed]
0167-6806
8.
Byrski
T
,
Gronwald
J
,
Huzarski
T
,
Grzybowska
E
,
Budryk
M
,
Stawicka
M
, et al.
Pathologic complete response rates in young women with BRCA1-positive breast cancers after neoadjuvant chemotherapy
.
J Clin Oncol
.
2010
Jan
;
28
(
3
):
375
9
.
[PubMed]
0732-183X
9.
Narod
SA
,
Huzarski
T
,
Gronwald
J
,
Byrski
T
,
Marczyk
E
,
Cybulski
C
, et al.
Predictors of survival for breast cancer patients with a BRCA1 mutation
.
Breast Cancer Res Treat
.
2018
Apr
;
168
(
2
):
513
21
.
[PubMed]
0167-6806
10.
Wunderle
M
,
Gass
P
,
Häberle
L
,
Flesch
VM
,
Rauh
C
,
Bani
MR
, et al.
BRCA mutations and their influence on pathological complete response and prognosis in a clinical cohort of neoadjuvantly treated breast cancer patients
.
Breast Cancer Res Treat
.
2018
Aug
;
171
(
1
):
85
94
.
[PubMed]
0167-6806
11.
Hahnen
E
,
Lederer
B
,
Hauke
J
,
Loibl
S
,
Kröber
S
,
Schneeweiss
A
, et al.
Germline Mutation Status, Pathological Complete Response, and Disease-Free Survival in Triple-Negative Breast Cancer: Secondary Analysis of the GeparSixto Randomized Clinical Trial
.
JAMA Oncol
.
2017
Oct
;
3
(
10
):
1378
85
.
[PubMed]
2374-2437
12.
Fasching
PA
,
Loibl
S
,
Hu
C
,
Hart
SN
,
Shimelis
H
,
Moore
R
, et al.
BRCA1/2 Mutations and Bevacizumab in the Neoadjuvant Treatment of Breast Cancer: Response and Prognosis Results in Patients With Triple-Negative Breast Cancer From the GeparQuinto Study
.
J Clin Oncol
.
2018
Aug
;
36
(
22
):
2281
7
.
[PubMed]
0732-183X
13.
von Minckwitz
G
,
Untch
M
,
Blohmer
JU
,
Costa
SD
,
Eidtmann
H
,
Fasching
PA
, et al.
Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes
.
J Clin Oncol
.
2012
May
;
30
(
15
):
1796
804
.
[PubMed]
0732-183X
14.
Cortazar
P
,
Zhang
L
,
Untch
M
,
Mehta
K
,
Costantino
JP
,
Wolmark
N
, et al.
Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis
.
Lancet
.
2014
Jul
;
384
(
9938
):
164
72
.
[PubMed]
0140-6736
15.
Arun
B
,
Bayraktar
S
,
Liu
DD
,
Gutierrez Barrera
AM
,
Atchley
D
,
Pusztai
L
, et al.
Response to neoadjuvant systemic therapy for breast cancer in BRCA mutation carriers and noncarriers: a single-institution experience
.
J Clin Oncol
.
2011
Oct
;
29
(
28
):
3739
46
.
[PubMed]
0732-183X
16.
Beckmann
MW
,
Brucker
C
,
Hanf
V
,
Rauh
C
,
Bani
MR
,
Knob
S
, et al.
Quality assured health care in certified breast centers and improvement of the prognosis of breast cancer patients
.
Onkologie
.
2011
;
34
(
7
):
362
7
.
[PubMed]
0378-584X
17.
Wöckel
A
,
Festl
J
,
Stüber
T
,
Brust
K
,
Krockenberger
M
,
Heuschmann
PU
, et al.
Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer
.
Geburtshilfe Frauenheilkd
.
2018
Nov
;
78
(
11
):
1056
88
.
[PubMed]
0016-5751
18.
Wöckel
A
,
Festl
J
,
Stüber
T
,
Brust
K
,
Stangl
S
,
Heuschmann
PU
, et al.
Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 1 with Recommendations for the Screening, Diagnosis and Therapy of Breast Cancer
.
Geburtshilfe Frauenheilkd
.
2018
Oct
;
78
(
10
):
927
48
.
[PubMed]
0016-5751
19.
Gass
P
,
Lux
MP
,
Rauh
C
,
Hein
A
,
Bani
MR
,
Fiessler
C
, et al.
Prediction of pathological complete response and prognosis in patients with neoadjuvant treatment for triple-negative breast cancer
.
BMC Cancer
.
2018
Oct
;
18
(
1
):
1051
.
[PubMed]
1471-2407
20.
Fasching
PA
,
Loehberg
CR
,
Strissel
PL
,
Lux
MP
,
Bani
MR
,
Schrauder
M
, et al.
Single nucleotide polymorphisms of the aromatase gene (CYP19A1), HER2/neu status, and prognosis in breast cancer patients
.
Breast Cancer Res Treat
.
2008
Nov
;
112
(
1
):
89
98
.
[PubMed]
0167-6806
21.
Fasching
PA
,
Weihbrecht
S
,
Haeberle
L
,
Gasparyan
A
,
Villalobos
IE
,
Ma
Y
, et al.
HER2 and TOP2A amplification in a hospital-based cohort of breast cancer patients: associations with patient and tumor characteristics
.
Breast Cancer Res Treat
.
2014
May
;
145
(
1
):
193
203
.
[PubMed]
0167-6806
22.
Rauh
C
,
Hack
CC
,
Häberle
L
,
Hein
A
,
Engel
A
,
Schrauder
MG
, et al.
Percent Mammographic Density and Dense Area as Risk Factors for Breast Cancer
.
Geburtshilfe Frauenheilkd
.
2012
Aug
;
72
(
8
):
727
33
.
[PubMed]
0016-5751
23.
Michailidou
K
,
Hall
P
,
Gonzalez-Neira
A
,
Ghoussaini
M
,
Dennis
J
,
Milne
RL
, et al.;
Breast and Ovarian Cancer Susceptibility Collaboration
;
Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON)
;
kConFab Investigators
;
Australian Ovarian Cancer Study Group
;
GENICA (Gene Environment Interaction and Breast Cancer in Germany) Network
.
Large-scale genotyping identifies 41 new loci associated with breast cancer risk
.
Nat Genet
.
2013
Apr
;
45
(
4
):
353
61
.
[PubMed]
1061-4036
24.
Bojesen
SE
,
Pooley
KA
,
Johnatty
SE
,
Beesley
J
,
Michailidou
K
,
Tyrer
JP
, et al.;
Australian Cancer Study
;
Australian Ovarian Cancer Study
;
Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab)
;
Gene Environment Interaction and Breast Cancer (GENICA)
;
Swedish Breast Cancer Study (SWE-BRCA)
;
Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON)
;
Epidemiological study of BRCA1 & BRCA2 Mutation Carriers (EMBRACE)
;
Genetic Modifiers of Cancer Risk in BRCA1/2 Mutation Carriers (GEMO)
.
Multiple independent variants at the TERT locus are associated with telomere length and risks of breast and ovarian cancer
.
Nat Genet
.
2013
Apr
;
45
(
4
):
371
84
.
[PubMed]
1061-4036
25.
Fasching
PA
,
Pharoah
PD
,
Cox
A
,
Nevanlinna
H
,
Bojesen
SE
,
Karn
T
, et al.;
kConFab Investigators
.
The role of genetic breast cancer susceptibility variants as prognostic factors
.
Hum Mol Genet
.
2012
Sep
;
21
(
17
):
3926
39
.
[PubMed]
0964-6906
26.
Hammond
ME
,
Hayes
DF
,
Dowsett
M
,
Allred
DC
,
Hagerty
KL
,
Badve
S
, et al.
American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer
.
J Clin Oncol
.
2010
Jun
;
28
(
16
):
2784
95
.
[PubMed]
0732-183X
27.
Goldhirsch
A
,
Ingle
JN
,
Gelber
RD
,
Coates
AS
,
Thürlimann
B
,
Senn
HJ
;
Panel members
.
Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009
.
Ann Oncol
.
2009
Aug
;
20
(
8
):
1319
29
.
[PubMed]
0923-7534
28.
Salmen
J
,
Neugebauer
J
,
Fasching
PA
,
Haeberle
L
,
Huober
J
,
Wöckel
A
, et al.
Pooled analysis of the prognostic relevance of progesterone receptor status in five German cohort studies
.
Breast Cancer Res Treat
.
2014
Nov
;
148
(
1
):
143
51
.
[PubMed]
0167-6806
29.
Wunderle
M
,
Olmes
G
,
Häberle
L
,
Jud
SM
,
Hein
A
,
Rauh
C
, et al.
Risk, prediction and prevention of hereditary breast cancer – large scale genomic studies in the times of big and smart data
.
Geburtsh Frauenheilk
;
2018
.
30.
Couch
FJ
,
Hart
SN
,
Sharma
P
,
Toland
AE
,
Wang
X
,
Miron
P
, et al.
Inherited mutations in 17 breast cancer susceptibility genes among a large triple-negative breast cancer cohort unselected for family history of breast cancer
.
J Clin Oncol
.
2015
Feb
;
33
(
4
):
304
11
.
[PubMed]
0732-183X
31.
Couch
FJ
,
Shimelis
H
,
Hu
C
,
Hart
SN
,
Polley
EC
,
Na
J
, et al.
Associations Between Cancer Predisposition Testing Panel Genes and Breast Cancer
.
JAMA Oncol
.
2017
Sep
;
3
(
9
):
1190
6
.
[PubMed]
2374-2437
32.
Couch
FJ
,
Wang
X
,
McGuffog
L
,
Lee
A
,
Olswold
C
,
Kuchenbaecker
KB
, et al.;
kConFab Investigators
;
SWE-BRCA
;
Ontario Cancer Genetics Network
;
HEBON
;
EMBRACE
;
GEMO Study Collaborators
;
BCFR
;
CIMBA
.
Genome-wide association study in BRCA1 mutation carriers identifies novel loci associated with breast and ovarian cancer risk
.
PLoS Genet
.
2013
;
9
(
3
):
e1003212
.
[PubMed]
1553-7390
33.
Friebel
TM
,
Domchek
SM
,
Rebbeck
TR
.
Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis
.
J Natl Cancer Inst
.
2014
Jun
;
106
(
6
):
dju091
.
[PubMed]
0027-8874
34.
Fasching
PA
,
Ekici
AB
,
Wachter
DL
,
Hein
A
,
Bayer
CM
,
Häberle
L
, et al.
Breast Cancer Risk - From Genetics to Molecular Understanding of Pathogenesis
.
Geburtshilfe Frauenheilkd
.
2013
Dec
;
73
(
12
):
1228
35
.
[PubMed]
0016-5751
35.
Couch
FJ
,
Nathanson
KL
,
Offit
K
.
Two decades after BRCA: setting paradigms in personalized cancer care and prevention
.
Science
.
2014
Mar
;
343
(
6178
):
1466
70
.
[PubMed]
0036-8075
36.
Paluch-Shimon
S
,
Friedman
E
,
Berger
R
,
Papa
MZ
,
Dadiani
M
,
Friedman
N
, et al.
Does pathologic complete response predict for outcome in BRCA mutation carriers with triple-negative breast cancer? J Clin Oncol.
2014
;32:5s:(suppl; abstr 1023).
37.
Gonzalez-Angulo
AM
,
Timms
KM
,
Liu
S
,
Chen
H
,
Litton
JK
,
Potter
J
, et al.
Incidence and outcome of BRCA mutations in unselected patients with triple receptor-negative breast cancer
.
Clin Cancer Res
.
2011
Mar
;
17
(
5
):
1082
9
.
[PubMed]
1078-0432
38.
Copson
ER
,
Maishman
TC
,
Tapper
WJ
,
Cutress
RI
,
Greville-Heygate
S
,
Altman
DG
, et al.
Germline BRCA mutation and outcome in young-onset breast cancer (POSH): a prospective cohort study
.
Lancet Oncol
.
2018
Feb
;
19
(
2
):
169
80
.
[PubMed]
1470-2045
39.
Rennert
G
,
Bisland-Naggan
S
,
Barnett-Griness
O
,
Bar-Joseph
N
,
Zhang
S
,
Rennert
HS
, et al.
Clinical outcomes of breast cancer in carriers of BRCA1 and BRCA2 mutations
.
N Engl J Med
.
2007
Jul
;
357
(
2
):
115
23
.
[PubMed]
0028-4793
40.
Cortesi
L
,
Masini
C
,
Cirilli
C
,
Medici
V
,
Marchi
I
,
Cavazzini
G
, et al.
Favourable ten-year overall survival in a Caucasian population with high probability of hereditary breast cancer
.
BMC Cancer
.
2010
Mar
;
10
(
1
):
90
.
[PubMed]
1471-2407
41.
Goodwin
PJ
,
Phillips
KA
,
West
DW
,
Ennis
M
,
Hopper
JL
,
John
EM
, et al.
Breast cancer prognosis in BRCA1 and BRCA2 mutation carriers: an International Prospective Breast Cancer Family Registry population-based cohort study
.
J Clin Oncol
.
2012
Jan
;
30
(
1
):
19
26
.
[PubMed]
0732-183X
42.
Huzarski
T
,
Byrski
T
,
Gronwald
J
,
Górski
B
,
Domagala
P
,
Cybulski
C
, et al.
Ten-year survival in patients with BRCA1-negative and BRCA1-positive breast cancer
.
J Clin Oncol
.
2013
Sep
;
31
(
26
):
3191
6
.
[PubMed]
0732-183X
43.
Zhong
Q
,
Peng
HL
,
Zhao
X
,
Zhang
L
,
Hwang
WT
.
Effects of BRCA1- and BRCA2-related mutations on ovarian and breast cancer survival: a meta-analysis
.
Clin Cancer Res
.
2015
Jan
;
21
(
1
):
211
20
.
[PubMed]
1078-0432
44.
Baretta
Z
,
Mocellin
S
,
Goldin
E
,
Olopade
OI
,
Huo
D
.
Effect of BRCA germline mutations on breast cancer prognosis: A systematic review and meta-analysis
.
Medicine (Baltimore)
.
2016
Oct
;
95
(
40
):
e4975
.
[PubMed]
0025-7974
45.
Wang
YA
,
Jian
JW
,
Hung
CF
,
Peng
HP
,
Yang
CF
,
Cheng
HS
, et al.
Germline breast cancer susceptibility gene mutations and breast cancer outcomes
.
BMC Cancer
.
2018
Mar
;
18
(
1
):
315
.
[PubMed]
1471-2407
46.
van den Broek
AJ
,
Schmidt
MK
,
van ’t Veer
LJ
,
Tollenaar
RA
,
van Leeuwen
FE
.
Worse breast cancer prognosis of BRCA1/BRCA2 mutation carriers: what’s the evidence? A systematic review with meta-analysis
.
PLoS One
.
2015
Mar
;
10
(
3
):
e0120189
.
[PubMed]
1932-6203
47.
Cybulski
C
,
Kluźniak
W
,
Huzarski
T
,
Wokołorczyk
D
,
Kashyap
A
,
Jakubowska
A
, et al.;
Polish Hereditary Breast Cancer Consortium
.
Clinical outcomes in women with breast cancer and a PALB2 mutation: a prospective cohort analysis
.
Lancet Oncol
.
2015
Jun
;
16
(
6
):
638
44
.
[PubMed]
1470-2045
48.
Huzarski
T
,
Cybulski
C
,
Wokolorczyk
D
,
Jakubowska
A
,
Byrski
T
,
Gronwald
J
, et al.
Survival from breast cancer in patients with CHEK2 mutations
.
Breast Cancer Res Treat
.
2014
Apr
;
144
(
2
):
397
403
.
[PubMed]
0167-6806
49.
Weischer
M
,
Nordestgaard
BG
,
Pharoah
P
,
Bolla
MK
,
Nevanlinna
H
,
Van’t Veer
LJ
, et al.
CHEK2*1100delC heterozygosity in women with breast cancer associated with early death, breast cancer-specific death, and increased risk of a second breast cancer
.
J Clin Oncol
.
2012
Dec
;
30
(
35
):
4308
16
.
[PubMed]
0732-183X
50.
Liu
C
,
Chang
H
,
Li
XH
,
Qi
YF
,
Wang
JO
,
Zhang
Y
, et al.
Network Meta-Analysis on the Effects of DNA Damage Response-Related Gene Mutations on Overall Survival of Breast Cancer Based on TCGA Database
.
J Cell Biochem
.
2017
Dec
;
118
(
12
):
4728
34
.
[PubMed]
0730-2312
51.
Song
JL
,
Chen
C
,
Yuan
JP
,
Sun
SR
.
The association between prognosis of breast cancer and first-degree family history of breast or ovarian cancer: a systematic review and meta-analysis
.
Fam Cancer
.
2017
Jul
;
16
(
3
):
339
49
.
[PubMed]
1389-9600
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.