Voci A, et al. - This study aimed at assessing the timing of chemotherapy and choice of surgical procedures in patients with triple negative breast cancer (TNBC). Findings revealed an increase in the rate of neoadjuvant chemotherapy (NAC) use in these patients; however, there appeared significant decrease in BCT rates. This illustrated that in the treatment of TNBC, tumor burden alone did not predict timing of chemotherapy administration and surgical procedure.

Methods

• From 2010 to 2013, a cohort of women, aged ≥ 18 years old, with stage I-III TNBC diagnosis was identified using the National Cancer Data Base (NCDB).
• Researchers collected data regarding demographics, socioeconomic, and treatment factors.
• For statistical analysis, they used Chi-squared test, univariable, and multivariable logistic regression models.

Results

• 51,360 patients with TNBC were identified.
• 42,017 (82%) received chemotherapy treatment, and 13,185 (31%) of those received NAC.
• For NAC vs adjuvant chemotherapy (AC), significant predictors comprised age, year of diagnosis, income, insurance status, comorbidities, tumor size, nodal status, treatment center type, geographical location, and hospital volume.
• In this study, fifty-six percent (7,316) of NAC patients reported cN1-3, 17% (4,683) of AC patients reported cN1-3 and 9% (851) of no chemotherapy patients reported cN1-3.
• In the NAC cohort, overall pathologic complete response rate was 26.9%.
• On final pathology, 1529 (32%) of breast conservation (BC) and 1,941 (25%) of mastectomy patients had pT0.
• In patients treated with NAC, factors significant for BC vs mastectomy included age, race, year of diagnosis, comorbidities, tumor size, and nodal status.