Utilization of neoadjuvant chemotherapy varies in the treatment of women with invasive breast cancer

Onitilo, Adedayo A., Onesti, Jill K., Single, Richard M., Engel, Jessica M., James, Ted A., Bowles, Erin J. Aiello, Feigelson, Heather Spencer, Barney, Tom and McCahill, Laurence E. (2013) Utilization of neoadjuvant chemotherapy varies in the treatment of women with invasive breast cancer. PLoS One, 8 12: e84535.1-e84535.8. doi:10.1371/journal.pone.0084535

Author Onitilo, Adedayo A.
Onesti, Jill K.
Single, Richard M.
Engel, Jessica M.
James, Ted A.
Bowles, Erin J. Aiello
Feigelson, Heather Spencer
Barney, Tom
McCahill, Laurence E.
Title Utilization of neoadjuvant chemotherapy varies in the treatment of women with invasive breast cancer
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2013-12
Sub-type Article (original research)
DOI 10.1371/journal.pone.0084535
Open Access Status DOI
Volume 8
Issue 12
Start page e84535.1
End page e84535.8
Total pages 8
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2014
Language eng
Formatted abstract
Background: Treatment with neoadjuvant chemotherapy (NAC) has made it possible for some women to be successfully treated with breast conservation therapy (BCT ) who were initially considered ineligible. Factors related to current practice patterns of NAC use are important to understand particularly as the surgical treatment of invasive breast cancer has changed. The goal of this study was to determine variations in neoadjuvant chemotherapy use in a large multi-center national database of patients with breast cancer.

Methods: We evaluated NAC use in patients with initially operable invasive breast cancer and potential impact on breast conservation rates. Records of 2871 women ages 18-years and older diagnosed with 2907 invasive breast cancers from January 2003 to December 2008 at four institutions across the United States were examined using the Breast Cancer Surgical Outcomes (BRCASO) database. Main outcome measures included NAC use and association with pre-operatively identified clinical factors, surgical approach (partial mastectomy [PM] or total mastectomy [TM]), and BCT failure (initial PM followed by subsequent TM).

Results: Overall, NAC utilization was 3.8%l. Factors associated with NAC use included younger age, pre-operatively known positive nodal status, and increasing clinical tumor size. NAC use and BCT failure rates increased with clinical tumor size, and there was significant variation in NAC use across institutions. Initial TM frequency approached initial PM frequency for tumors >30-40mm; BCT failure rate was 22.7% for tumors >40mm. Only 2.7% of patients undergoing initial PM and 7.2% undergoing initial TM received NAC.

Conclusions: NAC use in this study was infrequent and varied among institutions. Infrequent NAC use in patients suggests that NAC may be underutilized in eligible patients desiring breast conservation.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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