Changes in chemotherapy usage and outcome of early breast cancer patients in the last decade

Abstract

BackgroundDuring the last decade, neoadjuvant chemotherapy (NACT) of early breast cancer (EBC) evolved from a therapy intended to enable operability to a standard treatment option aiming for increasing cure rates equivalent to adjuvant chemotherapy (ACT). In parallel, improvements in the quality control of breast cancer care have been established in specialized breast care units.Patients and methodsThis study analyzed chemotherapy usage in patients with EBC treated at the Heidelberg University Breast Unit between January 2003 and December 2014.ResultsOverall, 5703 patients were included in the analysis of whom 2222 (39 %) received chemotherapy, 817 (37 %) as NACT, and 1405 (63 %) as ACT. The chemotherapy usage declined from 48 % in 2003 to 34 % in 2014 of the cohort. Further, the proportion of NACT raised from 42 to 65 % irrespective of tumor subtype. In addition, frequency of pathologic complete response (pCR) defined as no tumor residues in breast and axilla (ypT0 ypN0) at surgery following NACT increased from 12 % in 2003 to 35 % in 2014. The greatest effect was observed in HER2+ breast cancer with an increase in patients achieving pCR from 24 to 68 %.ConclusionsThe results mirror the refined indication for chemotherapy in EBC and its preferred usage as NACT in Germany. The increase in pCR rate over time suggests improvement in outcome accomplished by a multidisciplinary decision-making process and stringent measures for quality control.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-016-4016-4) contains supplementary material, which is available to authorized users.

Update Mammakarzinom 2019 Teil 1 – Implementierung der Ergebnisse neuer Studienkonzepte beim frühen Mammakarzinom in die klinische Praxis

“…The prognosis of primary early breast cancer has continued to improve in the past few decades. This is seen in the improvement in the 5-year survival as well as in the increase in the rates of pathological complete remission (pCR) within the scope of neoadjuvant therapy concepts [1,2]. This suggests that not only optimisation of local therapy or early detection [3,4] improved prognosis but also systemic therapy.…”

Is Mastectomy Oncologically Safer than Breast-Conserving Treatment in Early Breast Cancer

“…This has led to the possibility of individually tailored treatment reducing the impact of local treatment on OS. In this context, particularly the progress in primary systemic therapy in the last decade has led to a rising rate of pathologic complete responses (pCRs) after neoadjuvant chemotherapy [24]. Reaching a pCR goes along with excellent prognosis for specific breast cancer subtypes (i.e.…”

Klaus-Dieter-Schulz-Versorgungsforschungspreis - Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade (2003–2014)

“…Anwendung von Chemotherapie, gesamt und für immunhistochemische Subtypen beim primären Mammakarzinom, Heidelberg, 2003 -2014 (n = 5703)[5]. Tab.…”

“…Tab. 2 pCR-Raten nach neoadjuvanter Chemotherapie, gesamt und für immunhistochemische Subtypen beim primären Mammakarzinom, Heidelberg, 2003 -2014 (n = 5703)[5]. NACT neoadjuvante Chemotherapie; ACT adjuvante Chemotherapie; pCR pathologische Komplettremission; TN triple negative; HR Hormonrezeptor.…”

“…NACT neoadjuvante Chemotherapie; ACT adjuvante Chemotherapie; pCR pathologische Komplettremission; TN triple negative; HR Hormonrezeptor. Rate von pathologischer Komplettremission (pCR, ypT0 ypN0) nach neoadjuvanter Chemotherapie (NACT) beim primären Mammakarzinom, Heidelberg 2003 -2014[5].…”