Neoadjuvant chemotherapy increases the rate of breast-conserving surgery

Abstract

Aim: To evaluate the pathological complete response and rate of breast-conserving surgery amongst primary breast cancer patients who underwent neoadjuvant chemotherapy followed by definitive breast surgery. Method: Retrospective cohort analysis of 392 primary breast cancer patients who underwent neoadjuvant chemotherapy followed by definitive breast surgery in Queen Mary Hospital & Tung Wah Hospital since 1997 were included. The rate of pathological complete response and rate of breast-conserving surgery were investigated. Results: Pathological complete response was observed in 12.2% of patients after neoadjuvant chemotherapy. Amongst them, 77% had human epidermal growth factor receptor 2 (HER2)-positive disease or triple-negative disease. Breast cancers with negative ER status (p = .004) or HER2+ve (p = .029) had a higher chance of pathological complete response in univariate analysis. The overall rate of breast-conserving surgery (BCS) increased to 30.5% from 14.7% after neoadjuvant chemotherapy, of which HER2-positive disease and triple-negative disease are associated with higher chance of BCS after neoadjuvant chemotherapy. Conclusion: Neoadjuvant chemotherapy is effective in downsizing the tumor, thus increasing the rate of breast-conserving surgery. It appears to be especially effective in HER2-positive disease and triple-negative disease.