Effect of time to breast cancer surgery after neoadjuvant chemotherapy on survival outcomes

Al‐Masri, Mahmoud; Aljalabneh, Basim; Al-Najjar, Hani; Al-Shamaileh, Tamador

doi:10.1007/s10549-020-06090-7

Cited by 17 publications

(7 citation statements)

References 18 publications

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“…In our trial the mean time between completion of NST and surgery was 34 days (26.5-40 days). This adequate interval is supported by current data recommending an interval of 4-8 weeks [26].…”

Section: Interval Between Nst and Surgerymentioning

confidence: 68%

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

Nussbaumer

Maggi

Castrezana

et al. 2022

Breast Cancer Res Treat

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Purpose The aim of the study was to analyze the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment. Methods This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I–IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021. Results Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5–40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p ≤ 0.001) and chronic pain (42.9% vs. 28.6%, p ≤ 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days). Conclusion In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.

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Section: Interval Between Nst and Surgerymentioning

confidence: 68%

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

Nussbaumer

Maggi

Castrezana

et al. 2022

Breast Cancer Res Treat

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“…After a median follow up of 3.8 years, all of the groups had an equivalent DFS. However, OS was worse for the group of patients who had their surgeries beyond 8 weeks compared to others [ 26 ]. Another study included 463 patients with breast cancer who received NAC between 2011 and 2017, and examined the relationship between the TTS-n and residual cancer burden (RCB) and oncologic outcomes.…”

Section: Time To Surgery Following Neoadjuvant Therapy (Tts-n)mentioning

confidence: 99%

Delays in Initiating Anti-Cancer Therapy for Early-Stage Breast Cancer—How Slow Can We Go?

Abdel‐Razeq

Mansour

Edaily

et al. 2023

JCM

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Breast cancer is the most commonly diagnosed cancer among women worldwide, and is a leading cause of cancer-related deaths. When diagnosed at an early stage, appropriate and timely treatment results in a high cure rate and better quality of life. Delays in initiating anti-cancer therapy, including surgical resection, adjuvant/neoadjuvant chemotherapy and radiation therapy are commonly encountered, even in developed health care systems. Existing comorbidities that mandate referral to other services, genetic counseling and testing that may dictate the extent and type of anti-cancer therapy and insurance coverage, are among the most commonly cited factors. However, delays can be unavoidable; for over three years, health care systems across the globe were busy dealing with the unprecedented COVID-19 pandemic. War across hot zones around the globe resulted in millions of refugees; most of them have no access to cancer care, and when/where available, there may be significant delays. Thus, cancer patients across the globe will probably continue to suffer from significant delays in diagnosis and appropriate treatment. Many retrospective reports showed significant negative impacts on different aspects of treatment outcomes and on patients’ psychosocial wellbeing and productivity. In this paper, we review the available data on the impact of delays in initiating appropriate treatment on the outcomes of patients with early-stage breast cancer.

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“…The administration of NAC not only makes conservative treatment possible, but also precision medicine according to its efficacy [ 1 ] and the evaluation of the pathologic response of the tumor in terms of achieving pathologic complete response (pCR) with rates ranging from 3% to 48% and a partial response with a rate of 61.2% [ 2 , 3 ]. It has been shown that pCR is a prognostic factor for disease-free survival (DFS) and overall survival (OS) [ 4 , 5 ], probably because it reflects the eradication of micrometastatic disease [ 5 ]. For this reason, predictive markers of response identification have been a topic of study for a long time; estrogen (ER) and progesterone receptors (PR) and human epidermal growth receptor 2 (HER2) status are the best known of these markers.…”

Section: Introductionmentioning

confidence: 99%

Hypoxia-Inducible Factor-1 Alpha Expression Is Predictive of Pathological Complete Response in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy

Ramírez-Tortosa

Alonso-Calderón

Gálvez-Navas

et al. 2022

Cancers

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To demonstrate the value of hypoxia-inducible factor-1α (HIF-1α) in predicting response in patients with breast cancer receiving standard neoadjuvant chemotherapy (NAC). Methods: Ninety-five women enrolled in two prospective studies underwent biopsies for the histopathological diagnosis of breast carcinoma before receiving NAC, based on anthracyclines and taxanes. For expression of HIF-1α, EGFR, pAKT and pMAPK, tumor samples were analyzed by immunohistochemistry in tissues microarrays. Standard statistical methods (Pearson chi-square test, Fisher exact test, Kruskal–Wallis test, Mann–Whitney test and Kaplan–Meier method) were used to study the association of HIF-1α with tumor response, survival and other clinicopathologic variables/biomarkers. Results: HIF-1α expression was positive in 35 (39.7%) cases and was significantly associated to complete pathological response (pCR) (p = 0.014). HIF-1α expression was correlated positively with tumor grade (p = 0.015) and Ki-67 expression (p = 0.001) and negativity with progesterone receptors (PR) (p = 0.04) and luminal A phenotype expression (p = 0.005). No correlation was found between HIF-1α expression and EGFR, pAKT and pMAPK. In terms of survival, HIF-1α expression was associated with a significantly shorter disease-free survival (p = 0.013), being identified as an independent prognostic factor in multivariate analysis. Conclusions: Overexpression of HIF-1α is a predictor of pCR and shorter DFS; it would be valuable to confirm these results in prospective studies.

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Effect of time to breast cancer surgery after neoadjuvant chemotherapy on survival outcomes

Cited by 17 publications

References 18 publications

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

Delays in Initiating Anti-Cancer Therapy for Early-Stage Breast Cancer—How Slow Can We Go?

Hypoxia-Inducible Factor-1 Alpha Expression Is Predictive of Pathological Complete Response in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy

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