{Reference Type}: Journal Article
{Title}: Neoadjuvant chemotherapy for triple-negative and Her2 +ve breast cancer: striving for the standard of care.
{Author}: Roberts A;Hallet J;Nguyen L;Coburn N;Wright FC;Gandhi S;Jerzak K;Eisen A;Look Hong NJ;
{Journal}: Breast Cancer Res Treat
{Volume}: 206
{Issue}: 2
{Year}: 2024 Jul 27
{Factor}: 4.624
{DOI}: 10.1007/s10549-024-07282-1
{Abstract}: <B>OBJECTIVE: </B>Neoadjuvant chemotherapy (NAC) for triple-negative (TN) and Her2-positive (HER2) breast cancers is supported by international guidelines as it can decrease extent of surgery, provide prognostic information, and allow response-driven adjuvant therapies. Our goal was to describe practice patterns for patients with TN and HER2-positive breast cancer and identify the factors associated with the receipt of NAC versus surgery as initial treatment.<BR><B>METHODS: </B>A retrospective population-based cohort study of adult women diagnosed with stage I-III TN or HER2-positive breast cancer (2012-2020) in Ontario was completed using linked administrative datasets. The primary outcome was NAC as first treatment. The association between NAC and patient, tumor, and practice-related factors was examined using multivariable logistic regression models.<BR><B>RESULTS: </B>Of 14,653 patients included, 23.9% (n = 3500) underwent NAC as first treatment. Patients who underwent NAC were more likely to be younger and have larger tumors, node-positive disease, and stage 3 disease. Of patients who underwent surgery first, 8.8% were seen by a medical oncologist prior to surgery. On multivariable analysis, increasing tumor size (T2 vs T1/T0: 2.75 (2.31-3.28)) and node-positive (N1 vs N0: OR 3.54 (2.92-4.30)) disease were both associated increased odds of receiving NAC.<BR><B>CONCLUSIONS: </B>A considerable proportion of patients with TN and HER2-positive breast cancer do not receive NAC as first treatment. Of those, most were not assessed by both a surgeon and medical oncologist prior to initiating therapy. This points toward potential gaps in multidisciplinary assessment and disparities in receipt of guideline-concordant care.