biostudies-literatureUnknownAn SJLineberger Comprehensive Cancer Center Core Support GrantNCI NIH HHSNIH HHS<h4>Background</h4>Nodal pathologic complete response (npCR) after neoadjuvant treatment in patients with node-positive breast cancer (BC) avoids the morbidity of axillary dissection. In this study, we aimed to identify predictors of npCR.<h4>Patients and methods</h4>Adult women with stage 2-3 BC and clinically positive nodes from 2011 to 2021 in the National Cancer Database who received neoadjuvant chemotherapy followed by surgery within 8 months were included. Predictors of npCR were modeled with multivariable logistic regression.<h4>Results</h4>In total, 47,483 patients were included: 18,978 (40.0%) with npCR and 28,505 (60.0%) with nodal residual disease (nRD). Median age for the npCR group was 53 years (interquartile range [IQR] 21-90 years) compared with 54 years (IQR 21-90 years, p < 0.001) in the nRD group. Triple negative breast cancer (TNBC) was the most common subtype (53.5%) in the npCR group while ER+/HER2- was the most common (46.5%) in the nRD group, p < 0.001. After adjusting for sociodemographic factors, comorbidities, tumor characteristics, and treatment, younger age (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.99-0.99), ER-/HER2+ compared with TNBC (OR 1.32, 95% CI 1.21-1.44), and receipt of immunotherapy (OR 1.60, 95% CI 1.46-1.74) were associated with npCR. Black patients were less likely to have npCR overall (OR 0.90, 95% CI 0.85-0.95) with TNBC and HER2+ tumors, but more likely in ER+/HER2- tumors.<h4>Conclusions</h4>Both tumor and sociodemographic factors were associated with npCR in patients with BC. Black compared with white patients were more likely to have npCR in the ER+/HER2- subtype but less likely in the hormone receptor-negative and HER2+ subtypes. Mechanisms underlying these differences should be further investigated.Annals of surgical oncologyhttps://www.ebi.ac.uk/biostudies/studies/S-EPMC12371429biostudies-literaturePredictors of Nodal Pathologic Complete Response After Neoadjuvant Chemotherapy in Breast Cancer.PMC12371429R37CA292075P30CA016086P30 CA016086K08CA280388R37 CA292075K08 CA280388Abdou YGSelfridge JMThai CHNCSpanheimer PMAn SJAgala CBfalsePredictors of Nodal Pathologic Complete Response After Neoadjuvant Chemotherapy in Breast Cancer.<h4>Background</h4>Nodal pathologic complete response (npCR) after neoadjuvant treatment in patients with node-positive breast cancer (BC) avoids the morbidity of axillary dissection. In this study, we aimed to identify predictors of npCR.<h4>Patients and methods</h4>Adult women with stage 2-3 BC and clinically positive nodes from 2011 to 2021 in the National Cancer Database who received neoadjuvant chemotherapy followed by surgery within 8 months were included. Predictors of npCR were modeled with multivariable logistic regression.<h4>Results</h4>In total, 47,483 patients were included: 18,978 (40.0%) with npCR and 28,505 (60.0%) with nodal residual disease (nRD). Median age for the npCR group was 53 years (interquartile range [IQR] 21-90 years) compared with 54 years (IQR 21-90 years, p < 0.001) in the nRD group. Triple negative breast cancer (TNBC) was the most common subtype (53.5%) in the npCR group while ER+/HER2- was the most common (46.5%) in the nRD group, p < 0.001. After adjusting for sociodemographic factors, comorbidities, tumor characteristics, and treatment, younger age (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.99-0.99), ER-/HER2+ compared with TNBC (OR 1.32, 95% CI 1.21-1.44), and receipt of immunotherapy (OR 1.60, 95% CI 1.46-1.74) were associated with npCR. Black patients were less likely to have npCR overall (OR 0.90, 95% CI 0.85-0.95) with TNBC and HER2+ tumors, but more likely in ER+/HER2- tumors.<h4>Conclusions</h4>Both tumor and sociodemographic factors were associated with npCR in patients with BC. Black compared with white patients were more likely to have npCR in the ER+/HER2- subtype but less likely in the hormone receptor-negative and HER2+ subtypes. Mechanisms underlying these differences should be further investigated.2025-01-01T00:00:00Z2025 Jul2026-05-08T10:43:15.07Z2026-04-07T23:46:47.868ZS-EPMC123714294068401710.1245/s10434-025-17906-5