Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: Does Presenting Stage Impact Overall Survival?

By: Julia Fiederlein Cipriano, MS
Posted: Thursday, May 2, 2024

According to Jennifer F. Carroll, MD, FACS, of the Mayo Clinic, Rochester, Minnesota, and colleagues, among patients with stage I to III triple-negative breast cancer who achieved a pathologic complete response and those with residual disease after neoadjuvant chemotherapy and surgery, the clinical stage at presentation may further stratify overall survival. Their findings, which were presented during the 2024 Society of Surgical Oncology (SSO) Annual Meeting (Abstract 9), warrant validation in other data sets.

Using the National Cancer Database, the investigators identified 11,967 patients with a pathologic complete response and 23,631 with residual disease. The estimated 10-year overall survival rate in those with a pathologic complete response was 89%. Patients who presented with cT3–T4/N+ disease demonstrated the lowest rate (79%). The rates seemed to be similar in those with cT3–T4/N0 vs cT0–T2/N+ disease (87% vs 88%; P = .85); however, both groups experienced significantly poorer outcomes than those with cT1–T2/N0 disease (91%).

Based on multivariable analysis, compared with patients with cT1–T2/N0 disease, the adjusted hazard ratios (aHR) for those with cT3–T4/N+, cT3–T4/N0, and cT0–T2/N+ disease were 3.7, 1.8, and 1.8, respectively (each, P < .001). The investigators continued to observe no significant difference between cT3–T4/N0 and cT0–T2/N+ disease (aHR = 1.0).

The estimated 10-year overall survival rate was 60% in patients with residual disease (vs pathologic complete response: P < .001); it was found to vary by presenting clinical T category and node status in a pattern similar to that seen in patients with a pathologic complete response. The rate seemed to be higher in patients with cT1–T2/N0 disease (73%) vs those with cT0–T2/N+ (57%), cT3–T4/N0 (55%), and cT3–T4/N+ (40%) disease. Overall survival did not appear to significantly differ between patients with residual disease and a pathologic complete response who presented as cT1–T2/N0 and cT3–T4/N+, respectively (aHR = 1.1).

Disclosure: Dr. Carroll reported no conflicts of interest. For full disclosures of the other study authors, visit sso2024.eventscribe.net.

2024 SSO Annual Meeting

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