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J Surg Oncol. 2017 Nov;116(6):665-670. doi: 10.1002/jso.24721. Epub 2017 Jul 3.

Impact of neoadjuvant chemotherapy on surgical outcomes among patients with hormone receptor positive breast cancer.

Author information

1
Department of Surgery, University of Michigan Health Systems, Ann Arbor, Michigan.

Abstract

BACKGROUND:

Pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) is a surrogate for outcome, but not necessarily conversion to BCT eligibility. We sought to examine the impact of NACT on surgical decision making among HR+ patients.

METHODS:

Our IRB-approved breast cancer database was queried for patients who underwent NACT, including the clinicopathologic data and surgeon's pre- and post-NACT assessment. Surgical conversion rate (SCR) was defined as patients ineligible for BCT prior to NACT, who were given the choice following NACT.

RESULTS:

Among 289 patients, pCR rates were highest among patients with HER2-enriched subtype (60%) and lowest in patients with luminal A disease (4%). Overall, the BCT rate was 41%, while 28% opted for bilateral mastectomy across subtypes. Despite a low pCR, the SCR was still high (54%) among patients with the luminal A subtype.

CONCLUSION:

Despite poor pCR rates, NACT still has potential to improve surgical outcomes among hormone receptor positive patients. The surgical conversion rate is a superior measure of the impact of NACT on surgical decision making than examining BCT rates.

KEYWORDS:

breast conservation; luminal A; mastectomy; neoadjuvant chemotherapy

PMID:
28672101
DOI:
10.1002/jso.24721
[Indexed for MEDLINE]
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