To compare outcomes in patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer who received either dose-dense neoadjuvant chemotherapy (NAC) with trastuzumab or standard-interval chemotherapy with trastuzumab. Patients with HER2-positive breast cancer who received NAC, including epirubicin and cyclophosphamide followed by paclitaxel with trastuzumab were included. Patients were divided into either the dose-dense or standard-interval group. We compared pathologic complete remission (pCR), distant disease-free survival (DDFS), event-free survival (EFS), and breast cancer-specific survival (BCSS) between the two groups. Two hundred (49.6%) patients received dose-dense NAC, and 203 (50.4%) received standard-interval NAC. The pCR rate was 38.4% in the dose-dense group and 29.2% in the standard-interval group (P = 0.052). In patients with lymph node (LN) metastases, the LN pCR rate was 70.9% in the dose-dense group and 56.5% in the standard-interval group (P = 0.037). After a median follow-up of 54.6 months, dose-dense chemotherapy presented an improvement on DDFS (hazard ratio [HR] = 0.49, 95% confidence interval [CI]: 0.19–1.28, EFS (HR = 0.54, 95% CI: 0.24–1.21), and BCSS (HR = 0.41, 95% CI: 0.11–1.51), but the difference was not significant. Compared with standard-interval chemotherapy, dose-dense chemotherapy resulted in a superior 5-year DDFS (100% vs. 75.3%, P = 0.017) and 5-year EFS (96.9% vs. 78.3%, P = 0.022) in patients younger than 40 years. HER2-positive patients can achieve a higher LN pCR rate with dose-dense NAC than with standard-interval NAC with trastuzumab. Better survival may also be achieved with dose-dense chemotherapy with trastuzumab than with standard-interval chemotherapy with trastuzumab among young patients (age ≤ 40 years).

比较接受曲妥珠单抗剂量密集新辅助化疗 (NAC) 或曲妥珠单抗标准间隔化疗的人表皮生长因子受体 2 (HER2) 阳性乳腺癌患者的结果。HER2 阳性乳腺癌患者接受了 NAC，包括表柔比星和环磷酰胺，然后是紫杉醇和曲妥珠单抗。患者被分为剂量密集组或标准间隔组。我们比较了两组的病理完全缓解 (pCR)、远处无病生存 (DDFS)、无事件生存 (EFS) 和乳腺癌特异性生存 (BCSS)。203 名 (49.6%) 患者接受了剂量密集型 NAC，203 名 (50.4%) 接受了标准间隔 NAC。剂量密集组的 pCR 率为 38.4%，标准间隔组为 29.2%。P  = 0.052）。在淋巴结 (LN) 转移患者中，剂量密集组的 LN pCR 率为 70.9%，标准间隔组为 56.5% ( P  = 0.037)。中位随访 54.6 个月后，剂量密集型化疗改善了 DDFS（风险比 [HR] = 0.49，95% 置信区间 [CI]：0.19-1.28，EFS（HR = 0.54，95% CI： 0.24–1.21) 和 BCSS (HR = 0.41, 95% CI: 0.11–1.51)，但差异不显着。与标准间隔化疗相比，剂量密集化疗导致优越的 5 年 DDFS（100%与 75.3%，P  = 0.017）和 5 年 EFS（96.9% 与 78.3%，P = 0.022) 在 40 岁以下的患者中。与使用曲妥珠单抗的标准间隔 NAC 相比，HER2 阳性患者使用剂量密集型 NAC 可以获得更高的 LN pCR 率。在年轻患者（年龄 ≤ 40 岁）中，与使用曲妥珠单抗的标准间隔化疗相比，使用曲妥珠单抗的剂量密集化疗也可以获得更好的生存率。