Expression of Survivin and HER-2 as Independent Predictive Factors for Treatment Response in Locally Advanced Breast Cancer: A Prospective Cohort Study

BACKGROUND: Locally advanced breast cancer (LABC) requires a multimodal approach, often starting with neoadjuvant chemotherapy (NACT) to reduce tumor size. However, response to NACT in LABC is highly variable. Predictive biomarkers such as HER-2 and Survivin may have the potential to predict treatment response and prognosis. This study aims to analyze the relationship between Survivin and HER-2 expression and the clinical response to NACT in LABC patients. METHODS: In this prospective cohort study, we enrolled 56 female LABC patients scheduled for a Taxane, Adriamycin, and Cyclophosphamide NACT regimen. Pre-treatment biopsy tissues were examined for Survivin and HER-2 expression via immunohistochemistry. Clinical response was evaluated after three cycles using the RECIST criteria. Data were analyzed using the Chi-Square test and multivariate logistic regression. RESULTS: High Survivin expression was found in 32/56 (57.1%) participants and positive HER-2 expression in 28/56 (50%). A significant correlation was found between high Survivin expression and HER-2 positivity (p=0.007). High Survivin expression (p