Article Type

Original Study


Objective In this work, we aimed to assess whether the high stromal-associated lymphocytes and their subtypes in pretreatment core biopsies from patients with invasive breast carcinoma have a predictive role in pathologic response to neoadjuvant chemotherapy (NACT). Background Tumor-infiltrating lymphocytes including stromal-associated lymphocytes in breast cancer are considered a form of the host immune response to malignancy. Several studies suggested that tumor-infiltrating lymphocytes could predict better response to NACT, but their roles in predicting complete pathologic response (pCR) rate after NACT still needs further evaluation. Patients and methods Stromal-associated lymphocytes were evaluated in 100 pretreatment core biopsies from primary breast cancer patients eligible for NACT. Cases were defined as lymphocyte-rich if the percentage of lymphocytes was more than 50% and also the lymphocytes were evaluated for CD20, CD3, CD8, and CD4. Type of pathological response to NACT was determined in post-therapy surgical specimens of the same patients, and we correlated between type of response to stromal-associated lymphocytes and their subtypes. Results pCR was detected in 22 (22%) breast cancer patients, partial pathologic response in 54 (54%), and no pathologic response in 24 (24%) patients. There was a significant association between percentage of stromal-associated lymphocytes and achievement of pCR rate (P = 0.006). In addition, high stromal-associated lymphocytes are significantly associated with advanced histological grade (P = 0.004), Ki-67 (P = 0.028), and negative estrogen receptor state (P = 0.015). Conclusion High stromal-associated lymphocytes and high percentage of CD8-positive T cells in stromal-associated lymphocytes could be reliable predictors for pCR rate after NACT.