Breast Cancer Coverage from Every Angle

Does Neoadjuvant Chemotherapy Streamline Breast Cancer Treatment?

By: Hillary Ojeda
Posted: Thursday, July 9, 2020

According to a study published in Cancer Medicine, starting chemotherapy before surgery does not appear to expedite the start or completion of treatment for breast cancer compared with performing surgery first. According to Richard J. Bleicher, MD, of the Fox Chase Cancer Center, Philadelphia, and colleagues, “Rapidity of treatment should not be considered a benefit of giving chemotherapy preoperatively.” The investigators also suggested that because of the size of their data set, the results may apply to the general population.

“Although it takes an average of 1 to 2 days longer to start chemotherapy in the United States, this is not clinically significant and does not suggest that chemotherapy first provides a disadvantage,” said Dr. Bleicher in a Fox Chase press release. “While we have assumed that neoadjuvant chemotherapy expedites the start of treatment relative to surgery, this is not true.”

Using data from the National Cancer Database, the authors analyzed information on 155,606 women who had been diagnosed with stages II to III breast cancer between 2004 and 2015. The women were treated at 1,500 facilities and had received both surgery and chemotherapy. A total of 28,241 received neoadjuvant chemotherapy, whereas 127,365 received adjuvant chemotherapy. The researchers studied how long each of the two groups of patients took to start their treatment and how long it took to finish treatment.

A significant difference between the two approaches was not observed. It took 33.4 days for the group receiving surgery first to start treatment and 35.6 days for the group receiving chemotherapy first to start treatment. Moreover, patients treated with neoadjuvant chemotherapy took significantly longer to start radiotherapy (240.8 vs. 218.2 days adjusted, P < .0001) and endocrine therapy (301.6 vs. 275.7 days adjusted, P < .0001) than those who received adjuvant chemotherapy.

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