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. 2024 Dec:78:103790.
doi: 10.1016/j.breast.2024.103790. Epub 2024 Aug 30.

Neoadjuvant chemotherapy for breast cancer in Italy: A Senonetwork analysis of 37,215 patients treated from 2017 to 2022

A De Luca  1 , M I Amabile  2 , F Santori  3 , S Di Matteo  4 , M Tomatis  5 , A Ponti  5 , F Frusone  1 , M Taffurelli  6 , C Tinterri  7 , L Marotti  8 , M Calabrese  9 , C Marchiò  10 , F Puglisi  11 , I Palumbo  12 , L Fortunato  13 ; Senonet Collaborative Group*
Affiliations

Neoadjuvant chemotherapy for breast cancer in Italy: A Senonetwork analysis of 37,215 patients treated from 2017 to 2022

A De Luca et al. Breast. 2024 Dec.

Erratum in

Abstract

Background: Adoption of neoadjuvant chemotherapy (NACT) in the "real world" has been poorly investigated. Aim of this study was to examine the rate of NACT in Italy, trends over time and determinants of therapeutic choices.

Methods: Senonetwork, the recognized network of Breast Centers in Italy, has developed a voluntary national data warehouse with the aim to monitor and improve treatments quality. A retrospective analysis was conducted among 58,661 breast cancer (BC) patients treated between 2017 and 2022 by 24 high-volume Breast Centers participating in the project.

Results: After subset exclusion, 37,215 primary BC patients were analysed, 32,933 underwent primary-breast-surgery and 4,282 underwent NACT. From 2017 to 2022, the overall NACT incidence increased particularly for HR-/HER2+, Triple-Negative, and HR+/HER2+ BC (p < 0.001). In cN + patients the recommendation to axillary lymph-node dissection after NACT decreased over time along with an increase of <4 lymph-nodes removed (p < 0.001). Immediate breast reconstruction and indication for nipple sparing mastectomy increased significantly over time (OR = 1.10, p = 0.011 and OR 1.14, p < 0.001, respectively). On multivariate analysis, there was a trend towards an increased adoption of conservative treatment for HR-/HER2+ (p = 0.01) and Triple Negative tumors (p = 0.06). Implementation of NACT varied significantly among Breast-Centers from 3.8 to 17.7 % (p < 0.001).

Conclusion: The impact of NACT on the subsequent surgical management is substantial and continues to evolve over time, resulting in less-extensive surgery. Even among high-volume Centers NACT implementation rate is still highly variable. Although we registered a significant increase in its use during the study period, these results need to be further improved.

Keywords: Breast cancer; Breast centers; Neoadiuvant chemotherapy.

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Figures

Fig. 1
Fig. 1
Flowchart of patients selection.
Fig. 2
Fig. 2
Incidence of NACT per year from 2017 to 2022, in different molecular subtypes of breast cancer patients. Abbreviations:NACT = neoadjuvant chemotherapy.
Fig. 3
Fig. 3
Incidence of NACT per year from 2017 to 2022, in different molecular subtypes: A in cT1 cN0 cases; B in cT2+ cN0 cases; C in cT1 cN + cases; D in cT2+ cN + cases. Abbreviations:NACT = neoadjuvant chemotherapy; cT2+: tumor size > 2 cm in diameter.
Fig. 4
Fig. 4
Variability in indication to NACT over time among Breast Centers participating in Senonet.
See this image and copyright information in PMC

References

    1. Blackwood O., Deb R. Multidisciplinary team approach in breast cancer care: benefits and challenges. Indian J Pathol Microbiol. 2020;63:S105–S112. doi: 10.4103/IJPM.IJPM_885_19. - DOI - PubMed
    1. Pfob A., Heil J. Breast and axillary surgery after neoadjuvant systemic treatment - a review of clinical routine recommendations and the latest clinical research. Breast. 2022;62:S7–S11. doi: 10.1016/j.breast.2022.01.008. - DOI - PMC - PubMed
    1. Wazir U., Mokbel K. De-Escalation of breast cancer surgery following neoadjuvant systemic therapy. Eur J Breast Health. 2022;18:6–12. - PMC - PubMed
    1. Fisher B., Bryant J., Wolmark N., et al. Effect of preoperative chemo- therapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998;16:2672–2685. - PubMed
    1. Rastogi P., Anderson S.J., Bear H.D., et al. Preoperative chemotherapy: updates of national surgical adjuvant breast and bowel project pro- tocols B-18 and B-27. J Clin Oncol. 2008;26:778–785. - PubMed

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