High Proliferation Predicts Pathological Complete Response to Neoadjuvant Chemotherapy in Early Breast Cancer

Background.

In the neoadjuvant setting, changes in the proliferation marker Ki67 are associated with primary endocrine treatment efficacy, but its value as a predictor of response to chemotherapy is still controversial.

Patients and Methods.

We analyzed 262 patients with centralized basal Ki67 immunohistochemical evaluation derived from 4 GEICAM (Spanish Breast Cancer Group) clinical trials of neoadjuvant chemotherapy for breast cancer. The objective was to identify the optimal threshold for Ki67 using the receiver-operating characteristic curve method to maximize its predictive value for chemotherapy benefit. We also evaluated the predictive role of the defined Ki67 cutoffs for molecular subtypes defined by estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2).

Results.

A basal Ki67 cutpoint of 50% predicted pathological complete response (pCR). Patients with Ki67 >50% achieved a pCR rate of 40% (36 of 91) versus a pCR rate of 19% in patients with Ki67 ≤50% (33 of 171) (p = .0004). Ki67 predictive value was especially relevant in ER-HER2− and ER-HER2+ patients (pCR rates of 42% and 64%, respectively, in patients with Ki67 >50% versus 15% and 45%, respectively, in patients with Ki67 ≤50%; p = .0337 and .3238, respectively). Both multivariate analyses confirmed the independent predictive value of the Ki67 cutpoint of 50%.

Conclusion.

Basal Ki67 proliferation index >50% should be considered an independent predictive factor for pCR reached after neoadjuvant chemotherapy, suggesting that cell proliferation is a phenomenon closely related to chemosensitivity. These findings could help to identify a group of patients with a potentially favorable long-term prognosis.

Implications for Practice:

The use of basal Ki67 status as a predictive factor of chemotherapy benefit could facilitate the identification of a patient subpopulation with high probability of achieving pathological complete response when treated with primary chemotherapy, and thus with a potentially favorable long-term prognosis.     

Predictors of Pathological Complete Response to Neoadjuvant Chemotherapy in Iranian Breast Cancer Patients

Background: Achievement of pathologic complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is associated with both overall survival and disease-free survival. The aim of present study was to identify clinical and pathological factors associated with achieving pCR in Iranian breast cancer patients receiving NAC. Methods: A retrospective review of all breast cancer patients treated with neoadjuvant chemotherapy between April 2012 and September 2016 at our institution was performed; 207 cases were evaluable for analysis. pCR was defined as having no residual invasive tumor in the breast surgical specimen removed following neoadjuvant therapy. Results: In univariate analysis, factors associated with pCR were age less than 35 years (p = 0.03), absence of Lymphovascular invasion (LVI) (p = 0.002) and negative hormone receptor status (p = 0.003). Hormone receptor status (P = 0.01; OR, 2.45; CI, 1.20 - 4.99) and LVI (P = 0.001; OR, 0.22; CI, 0.10 - 0.46) remained predictive variables in multivariate analysis after correction for the other variables. Conclusions: In conclusion, the results of this study suggests that presence of Lymphovascular invasion and positive hormone receptor status are associated with poorer response to neoadjuvant chemotherapy in breast cancer patients.     

Nomogram for Early Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer Combining Both Clinicopathological and Imaging Indicators

To construct a nomogram for early prediction of pathological complete response (pCR) in patients with breast cancer (BC) after neoadjuvant chemotherapy (NAC). A total of 257 patients with BC from the fourth hospital of Hebei Medical University were included in the study. The patients were divided into training (n = 128) and validation groups (n = 129). Variables were screened using univariate and multivariate logistic regression analyses, and the nomogram model was set up based on the training group. The training and validation groups were validated using the receiver operating characteristic (ROC) curves and calibration plots. The diagnostic value of the nomogram was evaluated using decision curve analysis (DCA). Indicators such as hormone receptor status, clinical TNM stage, and change rate in apparent diffusion coefficient of breast magnetic resonance imaging after two NAC cycles were used for nomogram construction. The calibration plots showed high consistency between nomogram-predicted and actual pCR probabilities in the training and validation groups. The areas under the curve of the ROC curve with discrimination ability were 0.942 and 0.921 in the training and validation groups, respectively. This showed an excellent discrimination ability of our nomogram for pCR prediction. Further, DCA showed favorable diagnostic value in our model. The nomogram may be instructive to clinicians for early prediction of pCR and helpful to adjust the treatment program on time in neoadjuvant management.     

乳腺癌激素受体表达对新辅助化疗后病理完全缓解的影响

[目的]探讨乳腺癌激素受体表达对新辅助化疗后病理完全缓解(pathological complete response,pCR)的影响。[方法]回顾性分析2019年11月至2021年10月于武汉大学人民医院首诊为乳腺癌行新辅助化疗并手术108例患者的临床病理资料。依据激素受体(hormone receptor,HR)和人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达将患者进行分组,单因素分析采用χ^(2)检验或Fisher精确概率法,两两比较采用Bonferroni校正。多因素分析采用Logistic回归。[结果]多因素分析显示雌激素受体(estrogen receptor,ER)及HER2为新辅助化疗后p CR的独立预测因子,ER阴性(OR=13.134,P<0.001)及HER2阳性(OR=0.200,P=0.003)的患者p CR率更高,HR+/HER2-组pCR率最低(2.4%)。亚组分析pCR率观察到统计学差异,差异存在于HR+/HER2-组与其他三组[Bonfeffoni校正,P均<0.0083(0.05/6)]。[结论]不同激素受体表达的乳腺癌患者对新辅助化疗的反应不同。ER阴性、HER2阳性的乳腺癌患者新辅助化疗的效果更好,更易达到pCR。     

Association between Pathological Complete Response and Outcome Following Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer Patients

Purpose

We aimed to determine the rate of pathological complete response (pCR), clinicopathological factors associated with pCR, and clinical outcomes following neoadjuvant chemotherapy in locally advanced breast cancer.

Methods

Medical records of patients who had undergone neoadjuvant chemotherapy for breast cancer between January 2007 and September 2011 were retrospectively reviewed, and the pCR rates were calculated according to three sets of criteria: the National Surgical Adjuvant Breast and Bowel Project (NSABP), the MD Anderson Cancer Center (MDACC), and the German Breast Group (GBG). Tumors were classified as luminal A like, luminal B like, human epidermal growth factor receptor 2 (HER2), or triple-negative. pCR and clinical outcome, including overall survival (OS) and disease-free survival (DFS) rates were analyzed at the median follow-up of 54.2 months.

Results

Of a total of 179 patients who had received neoadjuvant chemotherapy, 167 patients (93.3%) had locally advanced breast cancer and 12 patients (6.7%) had early-stage breast cancer. The majority of patients (152 patients, 89.4%) received anthracycline-based neoadjuvant chemotherapy. The objective clinical response rate was 61.5%, comprising clinical partial response in 5.5% and clinical complete response in 3.9% of patients. Twenty-one (11.7%), 20 (11.2%), and 17 patients (9.5%) achieved pCR according to NSABP, MDACC, and GBG definitions, respectively. pCR rates, as defined by NSABP, according to breast cancer subtype were 4.4%, 9.7%, 24.2%, and 19.2% in luminal A like, luminal B like, HER2, and triple-negative subtypes, respectively. Patients who achieved pCR had significantly better DFS (5-year DFS rates, 80% vs. 53%, p=0.030) and OS (5-year OS rates, 86% vs. 54%, p=0.042) than those who did not.

Conclusion

The pCR rate following neoadjuvant chemotherapy for breast cancer in Thai women attending our institution was 11.7%; pCR was more frequently observed in HER2 and triple-negative breast tumor subtypes. Patients who achieved pCR had significantly improved survival.     

A Case of Pathological Complete Response and Resolution of Dermatomyositis Following Neoadjuvant Chemotherapy in HER2-Positive Early Breast Cancer

Introduction. Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) mainly characterized by subacute muscle weakness and skin rash sometimes associated with malignancy. Case Presentation. A 61-year-old female was admitted to our hospital because of progressive proximal muscular weakness, heliotropic rash and left breast rash. Muscle biopsy findings were consistent with dermatomyositis (DM). A full panel of myositis associated (MAA) and specific antibodies (MSA) revealed the presence of anti-nuclear antibodies (1:160, speckled), Anti-Ro52 and anti TIF1-γ antibodies. A whole body Computed Tomography Scan showed three left mammary nodules and homolateral axillary lymphadenopathy. The breast biopsy confirmed the diagnosis of ductal carcinoma. Patient was initiated to neoadjuvant chemotherapy followed by surgery for cancer, and corticosteroid and intravenous immunoglobulins for DM with a complete resolution of muscle weakness and pathological complete response of breast cancer. Discussion and conclusion. Similar cases in literature are commonly referred to a first-line surgery and the role of neoadjuvant chemotherapy is debatable.     

Stromal Clusterin Expression Predicts Therapeutic Response to Neoadjuvant Chemotherapy in Triple Negative Breast Cancer

Background

Expression of clusterin correlates with tumor progression and therapeutic response in several human malignancies, including breast cancer. However, its predictive value in the neoadjuvant setting in breast cancer remains unexplored. The objective of this explorative study was to determine whether clusterin expression in breast cancer correlated with clinical pathologic characteristics and whether its expression was predictive of response to neoadjuvant chemotherapy (NAC).

系统免疫炎症指数与Luminal B型乳腺癌新辅助化疗病理完全缓解的关系

摘 要：［目的］ 探讨系统免疫炎症指数（systemic inflammation index,SII）与Luminal B型乳腺癌新辅助化疗病理完全缓解（pathological complete response,pCR）的关系。［方法］ 回顾性分析2015年1月至2017年1月在哈尔滨医科大学附属肿瘤医院198例接受新辅助化疗及手术的女性Luminal B型乳腺癌患者的临床病理资料。采用Logistic回归模型进行单因素和多因素分析SII与pCR的关系。［结果］ 37例患者获pCR,低SII组25例,高SII组12例,SII与pCR相关（P=0.018）。单因素分析显示：与Her-2阴性者相比,阳性者pCR更高(P<0.001);与Ki-67≤14%者相比,Ki-67＞14%者更易达到pCR(P=0.024);与低SII组相比,高SII组更难达到pCR(P=0.020)。多因素分析显示：与低SII组相比,高SII组较难获得pCR(P=0.019);与Her-2阴性者相比,Her-2阳性者pCR率更高(P=0.024);与Ki-67≤14%者相比,Ki-67＞14%者pCR率更高(P=0.019)。 亚组分析显示：在低SII组中Luminal B/Her-2(+)亚组患者pCR率更高（χ2=9.764,P=0.002）;在高SII组中Luminal B/Her-2(+)亚组患者pCR率更高,但差异无统计学意义（χ2=3.556,P=0.059）。［结论］ SII值、Ki-67值及Her-2状态是Luminal B型乳腺癌新辅助化疗后pCR的独立预测因素,低SII且Luminal B/Her-2(+)组pCR率更高,与预后相关性有待进一步研究。     

The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer

Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor foroverall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio(NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials andMethods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinicaldata collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgeryafter chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed asignificant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growthfactor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantlylower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In LuminalB tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could bea useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemicinflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that wouldget the most benefit from NAC.     

Clinical and Radiologic Assessments to Predict Breast Cancer Pathologic Complete Response to Neoadjuvant Chemotherapy

SummaryPurpose. To prospectively compare the ability of clinical examination, mammography, vascularity-sensitive ultrasound, and magnetic resonance imaging (MRI) to determine pathologic complete response (CR) in breast cancer patients undergoing neoadjuvant chemotherapy.Patients and methods. Participants were women with primary measurable, operable invasive breast cancer (Stages I–III) who presented to the University of Michigan Breast Care Center. Eligibility criteria were based on clinical need for chemotherapy as part of the overall treatment plan. The chemotherapy consisted of doxorubicin and docetaxel administered every 3 weeks for four cycles. Tumor size measurements by physical examination and by the three imaging modalities were performed before chemotherapy was initiated and after its completion, prior to definitive surgery. Response criteria were pre-specified in this prospective design, and study radiologists analyzed the mammographic, sonographic and MRI image sets blinded to information from the other modalities and blinded to final histological diagnosis. The pathologic CR rate obtained by the clinical and imaging modalities was compared to pathologic CR as determined pathologically.Results. 41 of 43 enrolled patients had a determination of pathologic response, and 4 patients had a pathologic CR to this chemotherapy (9.8%). The accuracy of physical examination, mammography, ultrasound, and MRI in determining pathologic CR was 75, 89, 82, and 89% respectively (NS).Conclusion. Biopsy after neoadjuvant chemotherapy remains absolutely necessary to determine pathologic CR to neoadjuvant chemotherapy, as the accuracy of current imaging modalities is insufficient to make this determination. The accuracy of mammography, vascularity-sensitive ultrasound, and MRI were not observed to be significantly different.     

Sentinel Lymph Node Biopsy in Breast Cancer Patients With Pathological Complete Response in the Axillary Lymph Node After Neoadjuvant Chemotherapy

PurposeSentinel lymph node biopsy (SLNB) alone following neoadjuvant chemotherapy (NAC) remains controversial in patients with breast cancer who are initially lymph node-positive. The present study aimed to evaluate the impact of SLNB and axillary lymph node dissection (ALND) on breast cancer recurrence and survival in patients who converted from lymph node-positive to pathological node-negative (ypN0) after NAC.MethodsThis single-center retrospective study included 223 patients who converted to axillary lymph node-negative status after NAC and underwent breast and axillary surgery between January 2006 and December 2015. This study compared the overall survival (OS), disease-free survival (DFS), ipsilateral axillary lymph node recurrence rates and incidence of postoperative complications, especially, arm lymphedema and shoulder stiffness between SLNB and ALND.ResultsThis study included 223 patients with axillary pathological complete response (pCR) after NAC and surgery. The SLNB and ALND groups included 94 and 129 patients, respectively. The median follow-up time was 57 (range, 6–155) in the SLNB group and 99 (range 2–159) months in the ALND group. The corresponding 5-year OS and DFS rates were 96.3% and 94.2% (p = 0.392), and 89.2% and 86.4% (p = 0.671), respectively. Four patients (4.3%) in the SLNB group and nine (7.0%) in the ALND group developed locoregional recurrences. Ipsilateral axillary lymph node recurrence and distant metastasis were observed in one (1.1%) and three (2.3%) patients, and in 10 (10.6%) and 11 (8.5%) patients, respectively. Patients in the ALND group were more likely than their SLNB counterparts to experience complications, such as shoulder stiffness (9 [7.0%] vs. 4 [4.3%] patients, p = 0.57). The rate of lymphedema in the ALND group was three times that in the SLNB group (35 [27.1%] vs. 8 [8.5%] patients, p < 0.001).ConclusionAs an alternative to ALND, SLNB has oncological safety in patients with axillary pathological complete response after NAC.     

Response of Triple Negative Breast Cancer to Neoadjuvant Chemotherapy: Correlation between Ki-67 Expression and Pathological Response

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6–8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.     

Predictive Value of IHC4 Score for Pathological Response to Neoadjuvant Chemotherapy in Hormone Receptor-Positive Breast Cancer

Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a lower IHC4 score was associated with an increased probability of pCR (low; 52.9% vs. High; 21.6%, OR=4.1, 95% CI= 1.28-13.16, p=0.018) and a lower pathological stage (OR =3.9, 95% CI=1.34-11.33, p=0.012). When the IHC4 score was treated as a continuous variable, a lower score was again associated with an increased probability of pCR (OR=1.010, 95% CI=1.001-1.018, p=0.025) and lower pathological stage (OR=1.009, 95% CI= 1.002-1.017, P=0.008). Lower clinical stage was associated with a better pCR rate that was of borderline significance (P=0.056). When clinical stage and IHC4 score were incorporated together in a logistic model, the likelihood ratio test gave a P-value of 0.004 after removal of the IHC4 score and 0.011 after removal of the stage, indicating a more significant predictive value of the IHC4 score for pCR. Conclusions: This study suggests that the IHC4 score can predict pathological response to neoadjuvant chemotherapy in HR-positive BC patients. This finding now needs to be validated in a larger cohort of patients.     

结合超声特征的腋窝淋巴结阳性乳腺癌新辅助化疗后腋窝病理完全缓解的预测模型

摘 要：［目的］ 分析经空芯针穿刺活检证实腋窝淋巴结阳性乳腺癌患者新辅助化疗（neoadjuvant chemotherapy,NAC）后腋窝病理完全缓解(pathological complete response,pCR)率及其影响因素,并整合超声影像特征与已知的临床病理特征建立预测模型,为新辅助化疗后乳腺癌患者腋窝处理的降级提供信息。［方法］ 回顾性分析哈尔滨医科大学附属肿瘤医院2017年1月至2018年12月入院接受NAC的481例乳腺癌患者的临床病理资料及超声影像特征,使用Logistic回归模型对临床病理特征及超声特征与NAC后腋窝淋巴结pCR的关系进行单因素及多因素分析,采用多因素分析中具有独立预测作用的指标构建新辅助化疗后腋窝pCR的预测列线图,并采用受试者工作特征（receiver operating characteristic,ROC）曲线及Bootstrapping法对此模型进行验证与校准。［结果］ 在481例患者中有147例(30.6%)实现了腋窝pCR。 单因素分析显示分子分型、乳腺原发灶临床疗效、淋巴结皮髓质分界是否清晰、彩色多谱勒血流图是否存在血流信号、淋巴结长径、淋巴结短径与腋窝pCR相关。多因素分析显示分子分型、乳腺原发灶临床疗效、CDFI血流信号、淋巴结短径是腋窝pCR的独立预测因素。与单独使用临床病理特征的预测模型相比,该模型具有良好的识别性能（ROC曲线下面积,0.784 vs 0.694,P<0.001）。［结论］ 结合超声特征的腋窝淋巴结阳性乳腺癌新辅助化疗后腋窝pCR的预测模型提高了仅应用临床病理特征的模型的预测能力,为NAC后选择合适的患者进行侵入性较小的腋窝手术方式提供了参考依据。     

系统免疫炎性反应指数对乳腺癌新辅助化疗病理完全缓解的预测作用及其与p53的关系

目的探讨系统免疫炎性反应指数(SII)对乳腺癌新辅助化疗(NAC)病理完全缓解(pCR)的预测作用及其与p53的关系。方法回顾性分析387例接受新辅助化疗及手术的女性乳腺癌患者临床病理资料。Logistic回归模型进行单因素和多因素分析。结果 72例(18.6%)患者接受新辅助化疗后获得了pCR,其中低SII组48例,高SII组24例;p53阴性组39例,阳性组33例。单因素分析显示:pCR与临床T分期、激素受体(HR)状态、人表皮生长因子受体2(HER2)、Ki67值、分子分型、p53及SII相关(均P<0.05);多因素分析显示:临床T分期、Ki67值、分子分型、p53及SII是影响乳腺癌患者pCR的独立预测因素。p53阴性的低SII组患者pCR率高于其他组。结论 SII是乳腺癌新辅助化疗病理完全缓解的独立预测因素,具有简单方便及重复性高等特点,p53阴性的低SII组患者pCR率高。     

CD24 Polymorphisms Cannot Predict Pathologic Complete Response to Anthracycline- and Taxane-Based Neoadjuvant Chemotherapy in Breast Cancer

IntroductionTo evaluate the correlations between CD24 polymorphisms and clinicopathologic variables of patients with breast cancer.Patients and MethodsSingle-nucleotide polymorphisms (SNPs) of CD24 were genotyped by the Sequenom MassArray iPLEX Gold System in 170 patients with breast cancer, and a total of 120 patients with histologically confirmed T2-4N0-2 M0 breast cancer were recruited to therapy with docetaxel, doxorubicin, and cyclophosphamide (TAC) as neoadjuvant chemotherapy. Data were analyzed by the chi-square test and logistic regression analysis.ResultsThere were no significant correlations between CD24 polymorphisms and any of the clinicopathologic variables, and no significant associations were found between either of the polymorphisms and CD24 protein expression. The clinical response rate and the pathologic complete response (pCR) rate were 68.8% and 27.1% in patients with the CD24 rs3838646 CA/CA genotype, and 87.5% and 20.8% in CD24 CA/Del and Del/Del genotype. There were no statistically significant differences between the CA/CA group and the Del allele group. The clinical response rate was 85.4% in patients with the CD24 rs52812045 C/C genotype and 63.9% in patients with the CD24 C/T and T/T genotype. There was a statistically significant difference between the C/C group and the T allele group (odds ratio = 0.28; 95% confidence interval, 0.11-0.73, P = .01). The pCR rate was 29.2% in patients with the CD24 rs52812045 C/C genotype and 23.6% in patients with the CD24 C/T and T/T genotype. There were no statistically significant differences between the C/C group and the T allele group. In a multivariate analysis, there was no correlation between CD24 rs3838646 or rs52812045 genotype and pCR.ConclusionCD24 rs3838646 and rs52812045 polymorphism could not predict the pathologic complete response to anthracycline- and taxane-based neoadjuvant chemotherapy in breast cancer. Additional larger studies are required to confirm this finding.     

Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: Correlation between Androgen Receptor Expression and Pathological Response

Background: There is growing evidence that the response to chemotherapy may be affected by Androgen Receptor (AR) expression suggesting that triple-negative breast cancers (TNBC) AR+ and quadruple negative breast cancer (QNBC) subtypes may have different diseases behavior. Methodology: We retrospectively estimated the predictive value of the AR expression in stage II and stage III TNBC patients treated with neoadjuvant chemotherapy (NAC) and correlated with the rate of pathological response (pCR). Results: Of 89 TNBC patients, 29 patients (32.6%) were TNBC AR+ and 60 patients (67.4) were QNBC. Most of the patients were less than 60 years old. Of note, approximately 62% in the QNBC group were less than 40 years old compared with 39 % in the TNBC AR+ group. The Ki-67 expression was higher in the QNBC in comparison with TNBC AR+ being 86.7% and 65.5%, respectively. QNBC subgroup showed higher rates of pCR compared with TNBC; 60% and 24%, respectively. Higher Ki-67 expression, higher grade, and lymph node involvement were statistically significantly correlated with the rate of pCR in the QNBC group (p=0.02, p=0.04, and p=0.03, respectively). In contrast, no significant association was observed between pCR and clinical-pathological features in the TNBC AR+ group. Conclusion: Our results suggested that the AR expression in TNBC may be applied as a predictive marker for NAC. TNBC AR+ had a lower rate of pCR compared with QNBC, suggesting that this subtype may have a partial chemoresistance.