Recent Publications

On this page you will find information about and links to relevant neoadjuvant systematic therapy publications

 

Summary

This prospective multicentre trial investigated the accuracy of ultrasound-guided biopsies identifying breast pathologically complete response (pCR) after neoadjuvant systemic therapy (NST) in patients with radiological partial (rPR) or complete (rCR) on MRI. Eight ultrasound-guided 14-G core biopsies were obtained before surgery close to the marker clip. Pre-surgical biopsies were obtained in 167 patients (136 rCR / 31 rPR) who had hormone receptor positive/HER2 negative (38%), HER2 positive (38%), or triple negative (36%) breast cancer. The pCR rate was 53% in the entire cohort. Of 78 patients who had residual disease, biopsies were false negative in 29 patients (37%). the multivariable significantly associated with false negative biopsy was rCR (FNR 47%; p=0.01).

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Summary

This systematic review and meta-analysis examined whether the timing of surgery post-neoadjuvant chemotherapy (NACT) impacted overall survival (OS) and disease free survival (DFS). Five studies (including 8794 patients) were eligible for inclusion. Patients who had surgery <8 weeks post-NACT had significantly improved OS (OR 0.47) and DFS (OR 0.71). Furthermore, there were no survival advantages in having surgery <4 weeks post-NACT with no difference in pCR rate between those that had surgery <4 weeks and 4-8 weeks post-NACT.

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Annals of Surgery: Mar 2020 - Volume 271 - Issue 3 – p574-580

This study examined pathological complete response (pCR) in the breast and the axilla in 4084 patients treated with neoadjuvant chemotherapy (NACT). The data was derived from the Netherlands Cancer Registry. Overall breast pCR rate of 24.1% was observed in cT1-3N0-1 breast cancer patients treated with NACT. In patients who achieved breast pCR, 97.7% of clinically node negative (cN0) patients had no tumour in the lymph nodes (ypN0) post-NACT. Furthermore, 45% of cN1 patients had converted to ypN0 after NACT. The study findings support the need for future clinical trials to investigate potential de-escalation of axillary surgery in this patient cohort when image-guided tissue sampling identifies a breast pCR.