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Multicentre Study of 391 Breast Cancers  \nIslam M. Miligy 1,2, Nahla Badr 2, Andrea Stevens 3, David Spooner 3, Rachna Awasthi 1, Yasmeen Mir 4, Anuj Khurana 4, Vijay Sharma 4, Usha Chandaran 5, Emad A. Rakha 6, Yasmine Maurice 7, Daniel Kearns 1, Rami Oweis 8, Amal Asar 8, Alastair Ironside 9 and Abeer M. Shaaban 1,10, *  \nCitation: Miligy, I.M.; Badr, N.; Stevens, A.; Spooner, D.; Awasthi, R.; Mir, Y.; Khurana, A.; Sharma, V.; Chandaran, U.; Rakha, E.A.; et al. Pathological Changes Following Neoadjuvant Endocrine Therapy (NAET): A Multicentre Study of  \n391 Breast Cancers. Int. J. Mol. Sci. 2024, 25, 7381. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/ijms25137381](10.3390/ijms25137381)  \nAcademic Editor: Rocío GarcíaBecerra  \nReceived: 19 April 2024  \nRevised: 30 June 2024  \nAccepted: 2 July 2024  \nPublished: 5 July 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Cellular Pathology, Queen Elizabeth Hospital, Birmingham B15 2GW, UK; [islam.miligy@yahoo.com](islam.miligy@yahoo.com) (I.M.M.); [rachna.awasthi@uhb.nhs.uk](rachna.awasthi@uhb.nhs.uk) (R.A.); [daniel.kearns@uhb.nhs.uk](daniel.kearns@uhb.nhs.uk) (D.K.)  \n2 Histopathology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom 11352, Egypt; [nahla.badr@med.menofia.edu.eg](nahla.badr@med.menofia.edu.eg)  \n3 Oncology Department, Queen Elizabeth Hospital, Birmingham B15 2GW, UK;  \n[andrea.stevens@uhb.nhs.uk](andrea.stevens@uhb.nhs.uk) (A.S.); [david.spooner@nhs.net](david.spooner@nhs.net) (D.S.)  \n4 Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, UK; [yasmeen.mir@liverpoolft.nhs.uk](yasmeen.mir@liverpoolft.nhs.uk) (Y.M.); [anuj.khurana@liverpoolft.nhs.uk](anuj.khurana@liverpoolft.nhs.uk) (A.K.); [vijay.sharma@liverpoolft.nhs.uk](vijay.sharma@liverpoolft.nhs.uk) (V.S.)  \n5 Histopathology Department, Salford Royal Hospital, Salford M6 8HD, UK; [usha.chandran@nca.nhs.uk](usha.chandran@nca.nhs.uk)  \n6 Histopathology Department, Nottingham City Hospital, Nottingham NG5 1PB, UK; [emad.rakha@nottingham.ac.uk](emad.rakha@nottingham.ac.uk)  \n7 Histopathology Department, Heartlands General Hospital, Birmingham B9 5SS, UK; [yasmine.maurice@swft.nhs.uk](yasmine.maurice@swft.nhs.uk)  \n8 Histopathology Department, Rotherham Foundation Trust, Rotherham S60 2UD, UK;  \n[rami.oweis@nhs.net](rami.oweis@nhs.net) (R.O.); [amal.asar@nhs.net](amal.asar@nhs.net) (A.A.)  \n9 Department of Pathology, NHS Lothian, Edinburgh EH41 3PF, UK; [alastair.ironside@nhslothian.scot.nhs.uk](alastair.ironside@nhslothian.scot.nhs.uk)  \n10 Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2SY, UK  \n* Correspondence: [a.shaaban@bham.ac.uk](a.shaaban@bham.ac.uk); Tel.: +44-121-371-3356  \nAbstract: Oestrogen receptor (ER)-positive breast cancer (BC) is generally well responsive to endocrine therapy. Neoadjuvant endocrine therapy (NAET) is increasingly being used for downstaging ER-positive tumours. This study aims to analyse the effect of NAET on a well-characterised cohort of ER-positive BC with particular emphasis on receptor expression. This is a retrospective United Kingdom (UK) multicentre study of 391 patients who received NAET between October 2012 and October 2020 . Detailed analyses of the paired pre-and post-NAET morphological changes and hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expression were performed. The median duration of NAET was 86 days, with median survival and overall survival rates of 380 days and 93.4%, respectively. A total of 90.3% of cases achieved a pathological par","cbCaidfSemml4MKl","https://ap.wps.com/l/cbCaidfSemml4MKl","pdf",7010054,14,"English","# Introduction\n## Study Rationale and Background\n## Neoadjuvant Endocrine Therapy vs Chemotherapy","[{\"question\":\"What does the study analyze after neoadjuvant endocrine therapy (NAET)?\",\"answer\":\"It examines paired pre- and post-NAET morphological changes and hormone receptor (HR) and HER2 expression, highlighting receptor-specific and structural pathological alterations.\"},{\"question\":\"How many breast cancer patients received NAET, and what was the typical treatment duration?\",\"answer\":\"The study includes 391 ER-positive patients treated with NAET, with a median NAET duration of 86 days.\"},{\"question\":\"What pathological and biomarker changes were reported following NAET?\",\"answer\":\"Following NAET, breast cancer showed changes involving tumour stroma (e.g., central scarring, increased TILs) and significant shifts in PR and HER2 status, along with a decrease in HER2-low proportions in paired samples.\"}]","Pathological Changes Following Neoadjuvant Endocrine Therapy (NAET) - A Multicentre Study of 391 Breast Cancers | PDF",1789997449,35]