Discussion
tumor, breast tumors, febrile neutropenia, breast cancer, TNBC, depression
TUMOR, METASTASIS, BREAST TUMORS, FEBRILE NEUTROPENIA, BREAST CANCER
FEC 3 followed by docetaxel 3 had been one of representative preoperative/adjuvant chemotherapy regimens specified in the NCCN guidelines up to 2017.[The pCR rate in our present study series was low compared to the 26.1% level reported in the NSABP-B27 [Similar to previous studies, the higher Ki67 level among patients with the luminal type breast tumors in our present cohort was associated with a higher pCR. There was no significant correlation found between Ki-67 and the pCR rate in previous TNBC studies, or among these cases in our present study, and similar findings were also demonstrated in the prior Gepar TRIO trial [Our current multivariate analysis revealed that a ≥ 55% baseline Ki-67 labeling index with luminal (HR 2.1, 95% CI,1.04–4.25), and ≥ 4 lymph node metastases at surgery (HR 1.9, 95% CI, 1.07–3.51) seemed to be correlated with the 3Y DFS outcome. A previous study found that an age > 50, higher T and N clinical stage, or tumor size > 5 cm were independent risk factors for distant metastasis in TNBC [In our current cohort, febrile neutropenia was within the 11–34% range reported in previous studies [In terms of QoL outcomes in our present cohort, FEC3-D3 was non inferior to AC4-D4 when FACT B scores at all points of time were compared. The FACT-B score, including all subfactors, showed a gradual decrease during chemotherapy. These differences indicated that the chemotherapy affected the QoL. At the treatment baseline, the EWB had the lowest score whereas the FWB score was the lowest at the completion of the chemotherapy. The lowest sub-factor before the start of the chemotherapy was the EWB, and this was likely related to the previously described prevalence of depression in breast cancer patients [