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Impact of neoadjuvant chemotherapy on surgical outcomes among patients with hormone receptor positive breast cancer
Author(s) -
Hage Andrew N.,
Capriccioso Christina,
Brennan Julia,
Heiden Brendan,
Zheutlin Alexander,
Sabel Michael S.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24721
Subject(s) - medicine , breast cancer , mastectomy , chemotherapy , oncology , neoadjuvant therapy , hormone receptor , cancer , surgery
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.