Surgery and post-operative adjuvant therapies After 1-2 courses of chemotherapy, all patients received surgery. In the targeted chemotherapy group, 6 patients received classical radical mas- tectomy (Halsted), 10 modified radical mastec- tomy, 4 breast-conserving surgery and 4 palliative resection of breast cancer. In the control group, 9 patients received classical radical mastectomy (Halsted), 7 modified radical mastectomy, 2 breast- conserving surgery and 5 palliative resection of breast cancer. After surgery, adjuvant chemother- apy with previous regimen was performed for a total of 6 courses. In addition, 20 patients experi- enced radiotherapy. Clinical manifestations were observed during the study including changes in lesions, days of the treatment, complications (ad- verse effects were diagnosed according to Criteria for Acute and Subacute Toxicity by WHO), and the post-operative follow up was also carried out. Statistical analysis and ethical consideration Comparisons of means between two groups were done with t test and one way analysis of variance was used to analyse the difference in the means between multiple groups. A pairwise comparison was done with q test. The statistical analysis was performed with SPSS 10.0 statistic software pack- age. A value of P < 0.05 was considered statistically significant. The study was carried out according to the Helsinki Declaration. Results Short-term efficacy and changes in TNM stage and N stage after treatment In the targeted chemotherapy group, changes of local lesions were observed as early as 3 days af- ter chemotherapy. Oedema at the local lesion was attenuated and accompanied by the occurrence of fold, the superficial varicosity was alleviated, and the adherence between cancers and chest wall was improved. The mass size was decreased, and the lesion was softened and could be moved. The exudate in the ulcerated site was reduced, and the skin colour was changed into brownness (Figures 3, 4). In the targeted chemotherapy group, nine pa- tients achieved a clinical complete remission (cCR), thirteen patients achieved a partial remission (PR), one patient achieved state disease (SD), one patient achieved progress disease (PD); four pa- tients achieved a pathological complete remission He J et al. / Triple negative breast cancer 125 FIGURE 3. Lesions before targeted chemotherapy. FIGURE 4. The lesions were markedly improved after targeted chemotherapy. (pCR), and the remission rate (RR) was 91.67 % (22/24) (Figure 5~6). Residual carcinoma in situ was noted in 1 patient. The down-staging rate was 62.50% (15/24). In the control group, the changes of local lesions were observed at 10 days after chemo- therapy. The mass was softened and tumour size was reduced, which was more obvious 30 days af- ter chemotherapy. In the control group, there were 3, 11, 7, 2, and 1 patient with cCR, PR, SD, PD and pCR, respectively, and the RR was 60.87% (14/23). The down-staging rate was 39.13% (9/24). In the targeted chemotherapy group, of the 19 patients with an axillary lymph node metastasis, no metas- Radiol Oncol 2011; 45(2): 123-128.