Skip to main content
Journal cover image

Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer.

Publication ,  Journal Article
Prakash, I; Neely, NB; Thomas, SM; Sammons, S; Blitzblau, RC; DiLalla, GA; Hyslop, T; Menendez, CS; Plichta, JK; Rosenberger, LH; Fayanju, OM ...
Published in: Cancer Med
February 2022

BACKGROUND: Controversy exists regarding the optimal sequence of chemotherapy among women with operable node-negative breast cancers with high-risk tumor biology. We evaluated national patterns of neoadjuvant chemotherapy (NACT) use among women with early-stage HER2+, triple-negative (TNBC), and high-risk hormone receptor-positive (HR+) invasive breast cancers. METHODS: Women ≥18 years with cT1-2/cN0 HER2+, TNBC, or high recurrence risk score (≥31) HR+ invasive breast cancers who received chemotherapy were identified in the National Cancer Database (2010-2016). Cochran-Armitage and logistic regression examined temporal trends and likelihood of undergoing NACT versus adjuvant chemotherapy based on patient age and molecular subtype. RESULTS: Overall, 96,622 patients met study criteria; 25% received NACT and 75% underwent surgery first, with comparable 5-year estimates of overall survival (0.90, 95% CI 0.892-0.905 vs 0.91, 95% CI 0.907-0.913). During the study period, utilization of NACT increased from 14% to 36% and varied according to molecular subtype (year*molecular subtype p < 0.001, p-corrected < 0.001). Women with HER2+ (OR 4.17, 95% CI 3.70-4.60, p < 0.001, p-corrected < 0.001) and TNBC (OR 3.81, 95% CI 3.38-4.31, p < 0.001, p-corrected < 0.001) were more likely to receive NACT over time, without a change in use among those with HR+ disease (OR 1.58, 95% CI 0.88-2.87, p = 0.13, p-corrected = 0.17). CONCLUSION: Among women with early-stage triple-negative and HER2+ breast cancers, utilization of NACT increased over time, a trend that correlates with previously reported improved rates of pCR and options post-neoadjuvant treatment with residual disease. Future research is needed to better understand multidisciplinary decisions for NACT and implications for breast cancer patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

February 2022

Volume

11

Issue

4

Start / End Page

1099 / 1108

Location

United States

Related Subject Headings

  • Triple Negative Breast Neoplasms
  • Neoplasm, Residual
  • Neoadjuvant Therapy
  • Humans
  • Female
  • Chemotherapy, Adjuvant
  • Breast Neoplasms
  • Antineoplastic Combined Chemotherapy Protocols
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Prakash, I., Neely, N. B., Thomas, S. M., Sammons, S., Blitzblau, R. C., DiLalla, G. A., … Greenup, R. A. (2022). Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer. Cancer Med, 11(4), 1099–1108. https://doi.org/10.1002/cam4.4517
Prakash, Ipshita, N Ben Neely, Samantha M. Thomas, Sarah Sammons, Rachel C. Blitzblau, Gayle A. DiLalla, Terry Hyslop, et al. “Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer.Cancer Med 11, no. 4 (February 2022): 1099–1108. https://doi.org/10.1002/cam4.4517.
Prakash I, Neely NB, Thomas SM, Sammons S, Blitzblau RC, DiLalla GA, et al. Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer. Cancer Med. 2022 Feb;11(4):1099–108.
Prakash, Ipshita, et al. “Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer.Cancer Med, vol. 11, no. 4, Feb. 2022, pp. 1099–108. Pubmed, doi:10.1002/cam4.4517.
Prakash I, Neely NB, Thomas SM, Sammons S, Blitzblau RC, DiLalla GA, Hyslop T, Menendez CS, Plichta JK, Rosenberger LH, Fayanju OM, Hwang ES, Greenup RA. Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer. Cancer Med. 2022 Feb;11(4):1099–1108.
Journal cover image

Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

February 2022

Volume

11

Issue

4

Start / End Page

1099 / 1108

Location

United States

Related Subject Headings

  • Triple Negative Breast Neoplasms
  • Neoplasm, Residual
  • Neoadjuvant Therapy
  • Humans
  • Female
  • Chemotherapy, Adjuvant
  • Breast Neoplasms
  • Antineoplastic Combined Chemotherapy Protocols
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis