Purpose The combination of taxanes and anthracyclines is still the mainstay of chemotherapy for early breast cancer. Capecitabine is an active drug with a favorable toxicity profile, showing strong anti-tumor activity against metastatic breast cancer. This trial assessed the efficacy and safety of the TX regimen (docetaxel and capecitabine) and compared it with the TE (docetaxel and epirubicin) regimen in locally advanced or high risk early HER2-negative breast cancer. Patients and methods This randomized clinical trial was conducted at five academic centers in China. Eligible female patients were randomly assigned (1:1) to the TX (docetaxel 75 mg/m 2 d1 plus capecitabine 1000 mg/m 2 twice d1–14, q3w) or TE (docetaxel 75 mg/m 2 d1 plus epirubicin 75 mg/m 2 d1, q3w) groups for four cycles. The primary endpoint was a pathological complete response in the breast (pCR). Secondary endpoints included pCR in the breast and axilla, invasive disease-free survival (iDFS), overall survival (OS), and safety. Results Between September 1, 2012, and December 31, 2018, 113 HER2-negative patients were randomly assigned to the study groups (TX: n = 54; TE: n = 59). In the primary endpoint analysis, 14 patients in the TX group achieved a pCR, and nine patients in the TE group achieved a pCR (25.9% vs. 15.3%), with a not significant difference of 10.6% (95% CI -6.0–27.3%; P = 0.241). In a subgroup with high Ki-67 score, TX increased the pCR rate by 24.2% (95% CI 2.2–46.1%; P = 0.029). At the end of the 69-month median follow-up period, both groups had equivalent iDFS and OS rates. TX was associated with a higher incidence of hand-foot syndrome and less alopecia, with a manageable toxicity profile. Conclusion The anthracycline-free TX regimen yielded comparable pCR and long-term survival rates to the TE regimen. Thus, this anthracycline-free regimen could be considered in selected patients. Trial Registration ACTRN12613000206729 on 21/02/2013, retrospectively registered.

Background Although the ACOSOG Z0011 study showed that axillary lymph node dissection (ALND) could be avoided in a specific population of sentinel lymph node-positive patients, it is not widely accepted by Chinese surgeons. We conducted a prospective single-arm study to confirm whether or not the results of Z0011 are applicable to Chinese patients. Methods Patients conforming to the Z0011 criteria were prospectively enrolled at the Peking University People’s Hospital Breast Center from November 2014 to June 2019. The clinicopathological features of the study group were compared with those of the Z0011 study group. Lymphedema after surgery, the incidence of local-regional recurrence, and survival were analyzed. Results One hundred forty-two patients who met the Z0011 eligibility criteria were enrolled in this study; 115 underwent sentinel lymph node biopsy (SLNB) alone. Compared with the Z0011 trial, younger patients were included (median age, 52 [26–82] years vs 54 [25–90] years; P = 0.03). For clinical T stage, tumor histology, hormone status, lymphovascular invasion, and the number of positive sentinel lymph nodes (SLNs), no statistically significant differences were observed. More patients received adjuvant chemotherapy and endocrine therapy in this study (90.85% vs 58.0% and 80.99% vs 46.6% respectively, P <0.001). A similar percentage of patients received radiotherapy, but more nodal radiotherapy procedures were carried out in our study (54.5% vs 16.9%). After a median follow-up of 29 months, only 1 patient (0.9%) had ipsilateral breast tumor recurrence, and no regional recurrence occurred. Conclusion Our study showed that it is achievable to avoid ALND in patients eligible for Z0011 in China. Trial registration ClinicalTrials.gov. Registration number NCT03606616 . Retrospectively registered on 31 July 2018.

Purpose: The dilemma of undertreatment and overtreatment of elderly breast cancer patients is common. This study aimed to investigate clinicopathological features, treatment modalities, and survival in women diagnosed with breast cancer at age 70 years or over, and to assist clinicians in developing individualized treatment plans by balancing the risks of breast cancer-specific death (BCSD) and other cause-specific death (OCSD). Methods: This retrospective study included 420 women who were diagnosed with pathologically confirmed invasive breast cancer at age 70 years or older from January 2008 to December 2015 at Peking University People's Hospital (PKUPH). We collected baseline health status, tumor characteristics, treatment choices, and outcomes and created nomograms for clinicians to estimate individualized BCSD and OCSD risk directly. Results: During a median follow-up of 71.5 months (range 2 to 144 months) in patients with stage I–III tumors, breast cancer specific survival (BCSS) was 92.4% (376/407) and overall survival (OS) was 78.1% (318/407). There were 89 deaths, and 65.2% (58/89) were non-breast cancer related. Upon multivariate analysis by Cox regression model, tumor size, positive lymph nodes, Ki-67, and surgery were independent predictors of BCSS, and comorbidities, positive lymph nodes, Ki-67, surgery, and endocrine therapy were independent predictors of OS. Propensity score weighted (PSW) was applied to analyze therapeutic efficacy, and there was BCSS and OS benefit with surgery (both p < 0.001), BCSS benefit with chemotherapy (p = 0.029), BCSS and OS benefit with endocrine therapy (p = 0.006 and 0.004), and neither BCSS nor OS benefit with radiotherapy (RT) (p = 0.348 and 0.289). Competing-risk nomograms were developed to estimate cumulative mortality probabilities for BCSD and OCSD for individual patients according to clinicopathologic characteristics and treatments. The calibration curves displayed exceptionally, with C-indexes 0.714 for BCSD and 0.717 for OCSD. Conclusions: Older patients had greater risk of dying from non-breast cancer causes. Surgery, chemotherapy, and endocrine therapy were associated with improved survival. Competing risk nomograms allowed individual assessment of BCSD and OCSD, based on clinicopathological characteristics and treatment options, and can be used as a tool to help in choosing appropriate treatment strategies. This study was approved by the Peking University People's Hospital Research Ethics Board on September 4, 2018.

Background Although traditional intraoperative assessments (ie, frozen sections) may lower reoperation rates in patients with breast cancer, time/tissue limitations and accuracy concerns have discouraged their routine clinical use. Full-field optical coherence tomography (FFOCT) and dynamic cell imaging (DCI) are novel optical imaging techniques offering rapid histologic approximations that are unfettered by requisite handling steps. This study was conducted to determine the feasibility and diagnostic utility of FFOCT and DCI in examining breast and lymph node specimens during breast cancer surgery. Methods FFOCT and DCI were applied to normal and cancerous breast tissue, benign breast lesions, and resected axillary lymph nodes. The tissues were then subjected to conventional processing and staining (hematoxylin-eosin) for purposes of comparison. Results A total of 314 specimens, including 173 breast biopsies (malignant, 132; benign/normal, 41) and 141 resected lymph nodes (tumor-positive, 48; tumor-negative, 93), were obtained from 158 patients during breast surgery for prospective imaging evaluations. In breast cancer diagnosis, the minimum sensitivities (FFOCT, 85.6%; DCI, 88.6%) and specificities of optical imaging (FFOCT, 85.4%; DCI, 95.1%) were high, although they diverged somewhat in nodal assessments (FFOCT sensitivity, 66.7%; FFOCT specificity, 79.6%; DCI sensitivity, 83.3%; DCI specificity, 98.9%). Conclusions These timely and tissue-sparing optical imaging techniques proved highly accurate in diagnosing breast cancer and nodal metastasis. They compare favorably with routine histologic sections and demonstrate their promise in this setting.

Background We implemented selective use of frozen section (FS) to optimize accuracy and cost control in the intraoperative diagnosis of sentinel lymph node (SLN) in patients with breast cancer, guided by the Memorial Sloan Kettering Cancer Center (MSKCC) nodal metastasis risk prediction nomogram. Methods Surgical pathology records were reviewed, examining 2582 consecutive biopsies from 2552 patients with breast cancer to compare intraoperative FS diagnoses with postoperative final reports. We calculated sensitivity, specificity, and false-negative rates (FNRs) for various MSKCC risk levels, also analyzing axillary reoperation rates, with and without FS, and the number needed to treat (NNT) to avoid separate axillary lymph node dissection. Results The sensitivity, specificity, and FNR of FS were 84.7%, 99.9%, and 15.3%, respectively. FNR and MSKCC risk level negatively correlated (r = -0.86; P = .002). Axillary reoperation rate significantly declined if FS was done (FS: 4.0%; no FS: 36.4%; P = .002). In grouping patients by quartile of MSKCC risk, axillary reoperation rates were 16.7%, 25.1%, 38.7%, and 58.7% without FS, compared with 4.3%, 3.2%, 5.6%, 3.3% with FS and NNT correspondingly fell from 8.1 to 4.6, 3.0, and 1.8. Conclusions A stratified decision-making algorithm based on the MSKCC risk prediction model improved the effectiveness of FS during SLN biopsy to avoid axillary reoperation.

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1％ (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4％ and OS was 96.5％.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5％ and it was 2.5％ in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.

Objective To investigate the clinicopathological characteristics, treatment patterns and prognosis factors of female invasive breast cancer patients over 70 years old. Methods A total of 178 female invasive breast cancer patients over 70 years old were included in this retrospective study. Their clinicopathological characteristics, treatment options, including operation and adjuvant treatment, overall survival and prognostic factors were analyzed. Results These 178 patients accounted for 12.4% of all breast cancer patients registered in our institution during the same period; 83.7% of these patients were complicated with at least one comorbidity; stage T1 and T2 patients accounted for 46.1% and 36.5%, respectively, and major pathological type was invasive ductal carcinoma; positive ER and(or) PR patients accounted for 81.6%. Tumor size, lymph node status, TNM stage, PR status, comorbidities and axillary operation were found to be independent factors to influence chemotherapy by multivariate analysis. Age was the only factor to influence radiotherapy. The median follow-up was 51 months, the cumulative 3-and 5-year disease-free survival were 91.8% and 80.5%, and the 3-year overall survival was 94%. Factors affecting the prognosis were tumor size, lymph node status, TNM stage and operation options by univariate analysis. Insufficient treatment, especially insufficient chemotherapy, would affect elderly breast cancer patients' survival, without significant difference. Conclusion Female breast cancer patients over 70 years old are mainly with early-stage cancer, good pathologic types and prognosis. Treatment options are influenced by TNM stage, molecular types, age and comorbidities. Most causes of death are non-breast cancer specific. Surgery is still the most important treatment method to improve patients' survival.

Different biological subtype breast cancers respond differently to neoadjuvant chemotherapy, but it is unknown whether neoadjuvant or adjuvant chemotherapy leads to different long-term survival in each specific subtype although equal outcomes have been reported in general population. This study sought to clarify whether the selection of either neoadjuvant or adjuvant chemotherapy was linked to a differential survival benefit based on breast cancer subtypes.A prospectively maintained breast cancer database was queried from 2000 to 2008. All patients with a diagnosis of stage II and III breast cancer who received neoadjuvant or adjuvant chemotherapy were identified, only patients receiving docetaxel and epirubicin (TA) regimen were included. Patients were divided according to the administration of neoadjuvant or adjuvant chemotherapy. The biological subtypes were determined by immunohistochemical tests. The outcomes between neoadjuvant and adjuvant chemotherapy were compared in each different subtype. Kaplan-Meier curves were generated, and the Cox model was used to estimate the association between death risk and chemotherapy timing while adjusting for potentially confounding factors. P values < .05 were considered statistically significant.Of the 406 patients included, 201 (49.5%) received neoadjuvant chemotherapy, and 205 (50.5%) received an adjuvant TA regimen. Patients with the HER2+ and TNBC subtypes showed significantly higher pCR rates than patients with luminal types (P < .05). In general population, the neoadjuvant and adjuvant chemotherapy groups showed little survival variance (HR=1.15, 95% confidence interval (CI) .69-1.91, P=.60). In luminal B-like patients, neoadjuvant chemotherapy led to worse overall survival (OS) than adjuvant therapy (HR=2.92, 95%CI 1.20 to 8.31, P = .02). In patients with the HER2+ subtype, neoadjuvant treatment corresponded to better OS (HR = .10, 95%CI .02-.58, P = .01). In contrast, patients with luminal A-like (HR = 1.14, 95%CI .53-2.43, P = .74) and TNBC disease (HR = 1.00, 95%CI .27-3.73, P = >.99) who underwent neoadjuvant chemotherapy showed equivalent OS when compared to patients undergoing adjuvant therapy.Neoadjuvant versus adjuvant chemotherapy results in a disparate impact on overall survival among patients with variant subtype breast cancer. When neoadjuvant chemotherapy was given, luminal B-like patients showed worse outcome, while patients with HER2+ disease had better OS. Prospective studies are necessary to determine and optimize the timing of chemotherapy for breast cancers with different molecular backgrounds.

Recent studies show that near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has the potential to improve the performance of sentinel lymph node (SLN) mapping. The current cohort study was designed to assess the value of the combination of ICG and methylene blue (MB) dye in patients undergoing SLN biopsy.

1055 Background: Sentinel lymph node (SLN) biopsy became the standard of care for the staging of clinically negative axillary lymph node in patients with invasive breast cancer. Surgeons often request intra-operative frozen section assessment of SLN to guide treatment decision during the operation. This study was to assess whether this protocol was accurate and efficient. Methods: We retrospectively reviewed pathology records for consecutive breast cancer patients with frozen section of SLNB examined from 2012 to 2014. We defined paraffin section diagnosis as gold standard. Sensitivity, specificity, false negative rate, and false positive rate were calculated. The waiting time for frozen section analysis was record. Results: In total, 1116 cases involved frozen section evaluation of sentinel lymph nodes. The sensitivity, specificity of frozen section was 79.9%, 99.6% respectively. In 49 cases (20.1% of positive patients), the SLN was called negative during the intra-operative evaluation but positive on final examination (false negative). Furthermore, in another 3 patients, malignancy was only detected on frozen but not on paraffin sections (false positive). The waiting time for frozen diagnosis, unnecessary for true negative patients (77.8%), was 51±17 minutes, which is approximately 1.5 times the duration of a secondary axillary dissection (33±15). Only 17.4% patients from intra-operative half frozen section assessment. Conclusions: We do not recommend intra-operative frozen section to guide further axillary surgery, as the protocol of freezing half of SLN is not an accurate or an efficient method, with a relatively high false negative rate and some false positive cases which might make the axillary staging complicated.

Objective To evaluate intraoperative tracing of sentinel lymph node (SLN) by fluorescence imaging combined with methylene blue.Methods 214 early breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to combination group receiving indocyanine green (ICG) and methylene blue (MB) as the lymphatic mapping tracers and MB alone group.Intraoperative frozen section was performed,followed by conventional histopathology.Results In the combination group,subcutaneous lymphatic channels were successfully visualized in 103 patients and the detection rate was 96.3％.The fluorescence SLNs were successfully detected in 102 patients and the detection rate was 95.3％.In the combination group,sentinel lymph nodes were successfully identified in 105 patients,the SLNs detection rate was 98.1％.While in the dye alone group,the SLNs were found in 100 patients and the detection rate was 93.4％.The average number of detected SLNs was 3.1 (325/105) in combination group versus 2.4 (242/100) in dye alone group(t =-3.3,P =0.001).Twenty nine metastatic SLNs were found in 19 patients in the combination group vs.21 in 17 patients in MB group.Conclusions ICG is a visible lymphatic mapping tracer helping visualize the SLNs.The use of ICG fluorescence and MB increases lymph node detection rate.

1084 Background: Neoadjuvant chemotherapy was reported to lead to equal outcome with adjuvant therapy in operable breast cancer. However, different molecular subtypes show variant response to chemotherapy, which is associated with different long-term prognosis. This study was to clarify whether molecular subtypes lead to different outcome between neoadjuvant and adjuvant chemotherapy. Methods: We identified 406 patients with stage II-III breast cancer who were treated with neoadjuvant or adjuvant chemotherapy between 2000 and 2008. To minimize the confounding bias, only patients received taxanes and anthracycline based regimen (TA) were included. Cases were divided according to receipt of neoadjuvant and adjuvant therapy. Data were compared using χ2test and analysis of variance. Kaplan-Meier Curves were generated. Results: Of the 406 patients, 201(49.5%) received neoadjuvant chemotherapy and 205(50.5%) received adjuvant TA regimen. The pCR rate was 12.9%(26/201) in total, and 7%, 14%, 33.3%, 19.4% for Luminal A, Luminal B, HER2+ and Triple negative breast cancer(TNBC), respectively. The HER2+ and TNBC have significantly higher rates of pCR than Luminal type (p<0.05). In general the two groups showed little survival variance (p=0.073 for DFS and p=0. 601 for OS). In Luminal B, neoadjuvant settings led to worse disease free survival (DFS) and overall survival (OS) than adjuvant settings after controlling for the covariates associated with survival in unadjusted tests (HR=0.41, p=0.028 for DFS; HR=0.32, p=0.020 for OS). In HER2+ subtype, neoadjuvant group corresponded to better DFS and OS (HR=5.65, p=0.024 for DFS; HR=10.52, p=0.010 for OS). On the contrary, patients with TNBC and Luminal A undergoing neoadjuvant chemotherapy had equal DFS and OS compared with patients receiving adjuvant therapy (p>0.05). Conclusions: The results demonstrate survival difference between patients receiving neoadjuvant and adjuvant cytotoxic therapy in variant subtypes. Prospective studies are necessary to determine if the finding is durable and optimize the timing of chemotherapy for breast cancer with different molecular background.

e12006 Background: Methylene blue (MB) dye is widely used in China for sentinel lymph node biopsy (SLNB). Recently indocyanine green (ICG) was reported to be an innovative fluorescent tracer that could be visualized by near-infrared camera. In this study we compared the efficacy of combined use of ICG fluorescence and methylene blue eye versus methylene blue alone for SLNB in breast cancer patients. Methods: Two hundred and sixteen consecutive early breast cancer patients in our hospital underwent SLNB from December 2010 to May 2012, 107 patients received combined use of ICG and MB as the lymphatic mapping tracer and 109 patients received MB alone. In combination group, sentinel lymph nodes were identified by ICG fluorescence using a near-infrared camera and/or blue dye, while in blue dye alone group sentinel lymph nodes were identified as blue nodes along the blue lymphatic vessel. Intra-operative frozen section analysis was performed, followed by conventional histopathologic examination. Results: In combination group, subcutaneous lymphatic channels were successfully visualized in all the patients, 325 sentinel lymph nodes were identified in 105 patients. While in blue dye alone group, 242 SLNs were found in 100 patients. The detection rate was 98.1% vs. 91.7 %(p=0.033), the average number of SLNs was 3.1 versus 2.4(p<0.001). 29 metastatic SLNs were found in 19 patients by combination method vs. 21 metastatic SLNs in 17 patients by MB alone. No axillary recurrence was observed in either group during 16 months of median follow-up. Conclusions: The combined use of ICG fluorescence and MB enables visualized and more sensitive SLN detection than MB alone.

Neo-adjuvant chemotherapy for breast cancer substantially benefits patients who achieve pathological response. However, clinical or pathological response information can only be obtained a period of time after chemotherapy. The identification of novel bio-markers or the application of new technique that can be used to predict treatment response before chemotherapy would allow therapy to be tailored on an individual patient basis. The purpose of this study is to identify the chemo-sensitivity and chemo-resistance related proteins using antibody microarray profiling, and to develop a multi-protein predictive model for breast cancer. Total protein was extracted from core needle biopsy samples obtained from 15 patients before treatment with neo-adjuvant TA (combination of taxanes and anthracycline) chemotherapy. Protein profiling was analyzed by antibody microarray. 10 patients were used as training set to develop the predictive model using the software PAM(prediction analysis of microarray). Another 5 patients were used as a validation set to test the model. In cross-validation, the molecular predictive model showed an accuracy of 90%, in independent validation, the model classified the cases with an accuracy of 80%. In conclusion, the proteomic predictive model has the potential to predict pathological response to neo-adjuvant TA chemotherapy.

Objective To screen the proteins that are related to the sensitivity or resistance of neoadjuvant chemotherapy in breast cancer and to provide molecular basis on the prediction model.Methods 10 patients were included in this study,who received neo-adjuvant taxane and anthracyclinebased chemotherapy,total protein was extracted from core needle biopsy samples of which 5 were sensitive to neo-adjuvant chemotherapy and 5 were resistant to neo-adjuvant chemotherapy.The sensitivity criterion was based on Miller & Payne grading,grade 4 and grade 5 were considered as sensitive,grade 1 and grade 2 were considered as resistant.Protein profiling was analyzed by antibody microarray,then screening of sensitive and resistant related proteins and clustering analysis were conducted.Results Core needle biopsy can provide sufficient protein to conduct the antibody microarray analysis,61 differentially expressed proteins were identified,10 patients were grouped as sensitive or resistant to neo-adjuvant chemotherapy by clustering analysis with an accuracy of 100%.Conclusion Molecular subtype of breast cancer based on proteomic analysis has a potential value to predict the sensitivity to neo-adjuvant chemotherapy.

BACKGROUND:Triple negative breast cancer(TNBC)is characterized by estrogen receptor (ER) negative, progesterone receptor (PgR)negative and human epidermal growth factor receptor 2 (HER-2) negative. It is a high risk breast cancer that lacks the benefit of specific therapy targeting these proteins. In this study, we compared the response to neoadjuvant chemotherapy and disease free survival between patients with TNBC and non-TNBC.METHODS:151 patients were included in this study, who received neoadjuvant taxane and anthracycline-based chemotherapy at Peking University People's Hospital from 2002 to 2007. TNBC is defined by the lack of ER, PgR, and HER-2 expression by immunohistochemistry. Clinical and pathologic parameters, pathologic complete response(pCR)rates and survival measurements were compared between patients with TNBC and non-TNBC.RESULTS:21 of 151 patients (14%) had TNBC. Patients with TNBC compared with non-TNBC had significantly higher pCR rates(38% v 12%; p=0.002), but decreased disease-free survival rates(p=0.004). If pCR was achieved, patients with TNBC and non-TNBC had similar survival (p=0.497).CONCLUSIONS:Patients with TNBC have increased pCR rates compared with non-TNBC, and those with pCR achieved excellent disease free survival. However, patients who did not get pCR have significantly worse survival if they have TNBC compared with non-TNBC.

OBJECTIVE:Observe the side effects of adjuvant chemotherapy and radiotherapy concurrently after breast conservative surgery and investigate it feasible.METHODS:40 breast cancer patients of conservative surgery were divided into two groups randomizedly, 20 patients of the study group were given adjuvant chemotherapy and radiotherapy concurrently, 20 patients of the control group were given adjuvant thermotherapy and radiotherapy sequently. Observe the side effects of the patients in the two groups and follow them 6 months.RESULTS:The leukopenia within the third chemotherapeutic cycle and the oral mucitis within the fourth chemotherapeutic cycle in the study group were more severe than those in the control group (P < 0.05). The other side effects within every chemotherapeutic cycles were similar in both groups, including skin reaction in radiotherapeutic area, gastroenteric reaction, alopecia, arthralgia, neurotoxicity and abnormal hepatic function. Following the patients of the two groups in 6 months, there were no significance in hemogram, hepatic and renal function, electrocardiogram and chest x-ray.CONCLUSION:It is feasible and safe to give the adjuvant chemotherapy and radiotherapy concurrently to the breast cancer patients after conservative surgery.

Neo-adjuvant chemotherapy of epirubicin plus paclitaxel was administered to 23 patients with locally advanced breast cancer (including 13 cases of stage IIb, 6 of stage IIIa, and 4 of stage IIIb). All patients were female. They were treated with epirubicin 60 mg/m2, on day 1, by i.v. followed paclitaxel 150 mg/m2 by 3 hours continuous infusion on day 2 and every 3 weeks repeatedly. Premedication with dexamethasone, ondansetron, diphenhydramine and cimetidine were administered to prevent gastroenteric and allergic reactions before chemotherapy. Two to 4 cycles were used. Ten out of 23 patients had a complete response, 10 had partial response, and 3 had no change. The response rate was 87% (20/23). Six out of 23 patients underwent breast conserving surgery as tumor size had become smaller and downstaging was realized after neo-adjuvant chemotherapy. The major toxicities included neutropenia, myalgia, arthralgia, nephrotoxicity, gastroenteric reactions, alopecia and flushing to the face. However, these were well tolerated in these patients.

OBJECTIVE:To investigate the effect of Shenmai injection in promoting postoperative recovery of patients with breast cancer.METHODS:Eighty postoperative patients of breast cancer were selected and divided into two groups, the treated group (40 cases) was given intravenous Shenmai injection for 7 days and compared with the control group (40 cases) in wound healing time, postoperative drainage volume, complication and blood picture, and the NK cell, T-lymphocyte subsets (CD3, CD4, CD8), were compared before and after treatment.RESULTS:The wound healing time and postoperational complication in the treated group were less than those in the control group significantly. There was no difference between the two groups in WBC and platelet count, but the recovery of hemoglobin in the treated group was quicker than that in the control group significantly (P < 0.05), as comparing with the control group, the NK cell, CD4, CD4/CD8 ratio in the treated group were elevated faster than those in the control group significantly (P < 0.05).CONCLUSION:Shenmai injection was beneficial to the recovery of postoperative patients of breast cancer, to reducing the occurrence of complication and was favorable to conduct postoperative chemotherapy smoothly.