Breast cancer lumpectomy: fewer reoperations with neoadjuvant vs adjuvant chemotherapy

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Takeaway
  • Receipt of neoadjuvant chemotherapy vs receipt of postoperative chemotherapy is associated with fewer reoperations after lumpectomy for breast cancer.
Why this matters
  • Reoperation is common, with more than 1 in 5 patients treated with lumpectomy undergoing reoperation for perceived residual disease.
Study design
  • 71,627 patients with stages I-III breast cancer in the National Cancer Database (NCDB) were evaluated for type of chemotherapy and reoperation rates (RORs) using multivariable logistic regression modeling.
  • Funding: Gundersen Medical Foundation, Norma J. Vinger Center for Breast Care, University of Wiscosin La Crosse.
Key results
  • The RORs were 11.4% for those who received neoadjuvant chemotherapy vs 20.3% for those who received postoperative chemotherapy (unadjusted OR=0.53; P<.001).
  • The ORs for reoperations for patients with stage 1 cancer was 0.65 (P<.001), with stage II cancer was 0.50 (P<.001), and with stage III cancer was 0.27 (P<.001).
Limitation
  • There was some missing data for ROR because the NCDB does not have a field for ROR.