Utility of the CPS + EG score with real‑life data in patients with breast cancer undergoing neoadjuvant chemotherapy

Breast cancer is the most common type of cancer in women, and predicting disease progression through CPS and EG scoring is important for treatment and prognosis, especially after neoadjuvant chemotherapy. The present study aimed to evaluate the association between the clinical and pathological stage (CPS) + estrogen receptor status and histologic grade (EG) score and disease-free survival (DFS) and overall survival (OS) in patients with breast cancer undergoing neoadjuvant chemotherapy. Data from 148 patients with breast cancer who were treated with neoadjuvant chemotherapy in the Medical Oncology Clinic of Izmir Tepecik Training and Research Hospital between 2013-2018 were analyzed. The following variables were assessed: Demographic characteristics, tumor size, clinical staging, estrogen receptor status, tumor nuclear grade in biopsy material and postoperative pathological staging. CPS + EG scores were calculated using simultaneous estrogen receptor status and tumor nuclear grade parameters, which were developed using the Neoadjuvant Therapy Outcomes Calculator Software of the MD Anderson Cancer Center. The 5-year OS and DFS rates were evaluated, and the 5-year follow-up of the patients was analyzed. The median follow-up period was 76.5 months, and the median survival time was 104.1 months. The pathological complete response (pCR) rate was 23.6%. Patients with a pCR were revealed to have a significantly higher DFS rate compared with the non-pCR group (P=0.038). A significant decline in DFS was also demonstrated with increasing CPS + EG scores (P<0.001). Moreover, a CPS score of 3-4 (P<0.001) and a CPS + EG score of 3-4-5 (P<0.001) were significantly associated with a worse OS. In conclusion, the relationship between the CPS + EG score and survival is apparent in the real-world data in the present study. As the score increases, both the probability of recovery and OS decrease. Furthermore, the CPS + EG scoring system is an easy, free and accessible method to estimate prognosis.