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The Evaluation of Magee Equation 2 in Predicting Response and Outcome in Hormone Receptor-Positive and HER2-Negative Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Authors Saigosoom N, Sa-nguanraksa D, O-charoenrat E, Thumrongtaradol T, O-charoenrat P

Received 5 November 2019

Accepted for publication 27 March 2020

Published 8 April 2020 Volume 2020:12 Pages 2491—2499


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Dr Antonella D'Anneo

Napat Saigosoom,1,* Doonyapat Sa-nguanraksa,1,* Eng O-charoenrat,2 Thanawat Thumrongtaradol,1 Pornchai O-charoenrat1

1Division of Head, Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand; 2Faculty of Medical Sciences, University College London, London WC1E 6BT, UK

*These authors contributed equally to this work

Correspondence: Pornchai O-charoenrat
Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
Tel +66 2419 2837

Background and Purpose: Magee Equations have been developed as accurate tools for predicting response and clinical outcomes in breast cancer patients treated with adjuvant systemic therapy using basic clinicopathological parameters. This study aims to evaluate the alternative application of Magee Equation 2 score in predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in hormone receptor (HR)-positive, HER2-negative breast cancer.
Patients and Methods: Patients with HR-positive, HER2-negative breast cancer who received NAC from January 2010 to May 2018 at Siriraj Hospital, Mahidol University, Thailand, were recruited. Pre-treatment status of HR and HER2 was used to calculate the Magee Equation 2 scores. The pCR rates among different clinicopathological parameters were analyzed. Survival analysis was performed by Log-rank test. Kaplan–Meier survival curves were analyzed.
Results: A total of 215 patients were eligible. The pCR rates for low, intermediate, and high scores were 4.8%, 3.6%, and 23.8%, respectively. Patients with high scores had significantly higher size reduction and pCR rates compared to those with intermediate or low scores (p< 0.001). Those with high scores had higher rates of locoregional recurrence and death. The patients with high score had significantly lower overall survival (p=0.034).
Conclusion: Among patients with HR-positive and HER2-negative breast cancer treated with NAC, Magee Equation 2 might be used as a tool for predicting the pCR and clinical outcome.

Keywords: breast cancer, Magee Equation, neoadjuvant chemotherapy, pathologic complete response, survival

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