ArticleAnnals of surgical oncology2021
How Often Does Modern Neoadjuvant Chemotherapy Downstage Patients to Breast-Conserving Surgery?
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Oncologic and cosmetic outcomes of oncoplastic breast-conserving surgery after neoadjuvant systemic therapy: systematic review and meta-analysis.Breast cancer research and treatment · 2025Pooled it
- Curative effect of immediate reconstruction after neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Meta-Analysis of Shrinkage Mode After Neoadjuvant Chemotherapy for Breast Cancers: Association With Hormonal Receptor.Frontiers in oncology · 2021Pooled it
- Impact of Neoadjuvant Chemotherapy on Surgical Outcomes and Conversion to Node-Negativity in Invasive Lobular Breast Cancer: Analysis of Molecularly High-Risk Tumors by Histologic Subtype on the I-SPY2 Clinical Trial.Annals of surgical oncology · 2025Trial
- Intraoperative and Perioperative Outcomes of Breast-Conserving Surgery After Neoadjuvant Systemic Therapy: A Retrospective Cohort Study.Clinical breast cancer · 2026Article
- Does Multidisciplinary Clinic Impact Rates of Breast Conserving Therapy?Annals of surgical oncology · 2026Article
- A multicenter retrospective study of neoadjuvant chemotherapy and breast conservation rate in locally advanced breast cancer.Discover oncology · 2026Article
- Evaluating the impacts of previous breast surgery on surgical complications and aesthetic outcomes in reverse-sequence endoscopic-assisted nipple-sparing mastectomy with or without direct-to-implant breast reconstruction.Frontiers in oncology · 2026Article
- Locoregional Considerations for Invasive Lobular Carcinoma.Current breast cancer reports · 2026Review
- Tumor shrinkage patterns and optimal timing of response assessment during neoadjuvant therapy for breast cancer: a study based on multiparametric MRI.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Predictors of Nodal Pathologic Complete Response After Neoadjuvant Chemotherapy in Breast Cancer.Annals of surgical oncology · 2025Article
- A core outcome set for locoregional treatment reporting in neoadjuvant systemic breast cancer treatment trials.NPJ breast cancer · 2025Article
- Virtual Biomarkers and Simplified Metrics in the Modeling of Breast Cancer Neoadjuvant Therapy: A Proof-of-Concept Case Study Based on Diagnostic Imaging.Medical sciences (Basel, Switzerland) · 2025Article
- Predictors of response to neoadjuvant chemo-immunotherapy in metaplastic triple-negative breast cancer.NPJ breast cancer · 2025Article
- An Overview of the Importance of Neoadjuvant Systemic Therapy for Breast Cancer Patients: From the Society of Surgical Oncology and the American Society of Breast Surgeons.Annals of surgical oncology · 2025Review
- Neoadjuvant chemotherapy is not necessarily applicable to patients with LN1-3 positive Luminal-B type operable breast cancer.Scientific reports · 2025Article
- In-Breast Tumor Progression During Neoadjuvant Chemotherapy: Impact on and Factors Influencing Distant Recurrence-Free Survival.Annals of surgical oncology · 2024Article
- Neoadjuvant compared to adjuvant chemotherapy combined with trastuzumab in patients with HER2-positive breast cancer: a register-based cohort study.ESMO real world data and digital oncology · 2024Article
- Breast Cancer Statistics in Korea, 2021.Journal of breast cancer · 2024Review
- Developing machine learning models for personalized treatment strategies in early breast cancer patients undergoing neoadjuvant systemic therapy based on SEER database.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundNeoadjuvant chemotherapy (NAC) has been proven to increase breast-conserving surgery (BCS) rates, but data are limited on conversion rates from BCS-ineligible (BCSi) to BCS-eligible (BCSe), specifically, in patients with large tumors.
methodsConsecutive patients with stage I-III breast cancer treated with NAC from November 2013 to March 2019 were identified. BCS eligibility before and after NAC was prospectively determined. Patients deemed BCSi before NAC due to large tumor size were studied. Statistical analyses were conducted using Student's t-test, Wilcoxon rank sum test, Chi-square test, Fisher's test, and logistic regression.
resultsIn this study, 600 of 1353 cancers were BCSi with large tumors; 69% were non-BCS candidates, 31% were borderline-BCS (bBCS) candidates. Of non-BCS candidates, 69% became BCSe after NAC; 66% chose BCS, and 90% were successful. Among bBCS candidates, 87% were BCSe after NAC, 73% chose BCS, and 96% were successful. On univariate analysis, bBCS candidacy, lower cT stage, cN0 status, absence of calcifications, human epidermal growth factor receptor 2 positive (HER2+)/triple negative (TN) receptor status, poor differentiation, ductal histology, and breast pCR were associated with conversion to BCS eligibility. On multivariable analysis, receptor status (hormone receptor positive [HR+]/HER2- ref; odds ratio [OR] HER2+ 1.63, P = 0.047; HR-/HER2- OR, 2.26, P = 0.003) and breast pCR (OR 2.62, P < 0.001) predicted successful downstaging, while larger clinical tumor size (OR 0.86, P = 0.003), non-BCS candidacy (OR 0.46, P = 0.003), cN+ status (OR 0.54, P = 0.008), and calcifications (OR 0.56, P = 0.007) predicted lower downstaging rates.
conclusionIn patients with large tumors precluding BCS, conversion to BCS eligibility was high with NAC, particularly in bBCS candidates. HER2+/TN receptor status predicted successful downstaging, while lower downstaging rates were observed with larger tumors, cN+ status, and calcifications. These factors should be considered when selecting patients for NAC.
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