Neoadjuvant chemotherapy for primary operable breast cancer

INTRODUCTION: Neoadjuvant chemotherapy (NACT) has been found useful in downstaging tumours in women with primary operable breast cancer without increasing mortality. As a result of several studies supporting this, the Danish Breast Cancer Cooperative Group implemented new guidelines for the treatment of primary operable T2 N0/N1 M0 ductal carcinomas in late 2016, treating patients with six cycles of NACT. This study aimed to conduct a quality assessment of the efficacy of the NACT regime based on real-time data from a single Danish hospital. METHODS: A retrospective observational study was conducted at Odense University Hospital, Denmark, from the introduction of the NACT regime to December 2018. Patients were identified using the surgical department's registry. Through medical chart review, predefined outcomes were collected on tumour characteristics, surgical outcomes, treatment response and type of NACT treatment. Descriptive statistics and Fisher's exact test were used on relevant data. RESULTS: Among the 64 patients, 67% completed a recommended NACT regime. A 55% majority underwent lumpectomy and 64% were spared axillary dissection. Complete pathological response was found in 28% of patients. After treatment, 38% of the pre-NACT N1 patients were downstaged to N0. CONCLUSIONS: This study indicated that the NACT regime was a favourable treatment strategy for these patients. Two-thirds of patients were able to undergo a recommended NACT regime. The majority of patients were both spared axillary dissection and mastectomy.