ArticleAnnals of surgical oncology2021
Neoadjuvant Endocrine Therapy as an Alternative to Neoadjuvant Chemotherapy Among Hormone Receptor-Positive Breast Cancer Patients: Pathologic and Surgical Outcomes.
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 26 papers, 1 of them a synthesis that pooled it.
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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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Node-Positive HR+, HER2- Breast Cancer (Nodal pCR and the Rate of ALND): A Systematic Review and Meta-Analysis.The breast journal · 2024Pooled it
- Clinical efficacy and therapy response prediction of neoadjuvant dalpiciclib plus letrozole in postmenopausal patients with HR+/HER2- stage II-III breast cancer (DARLING 01): a single-arm, open-label, exploratory study.Breast cancer research : BCR · 2025Trial
- Local-Regional Recurrence After Neoadjuvant Endocrine Therapy: Data from ACOSOG Z1031 (Alliance), a Randomized Phase 2 Neoadjuvant Comparison Between Letrozole, Anastrozole, and Exemestane for Postmenopausal Women with Estrogen Receptor-Positive Clinical Stage 2 or 3 Breast Cancer.Annals of surgical oncology · 2023Trial
- Neoadjuvant endocrine therapy often leads to breast and axilla-conserving surgery in stages II and III hormone receptor-positive breast cancer patients: A registry study.International journal of cancer · 2026Article
- Profiles of research waste in randomized clinical trials comparing de-escalation and escalation strategies for breast cancer treatment.Frontiers in oncology · 2026Article
- Can neoadjuvant endocrine therapy de-escalate surgery in luminal breast cancer? A four-year retrospective study from a single referral center.Frontiers in oncology · 2026Article
- Contemporary Trends in Axillary Surgery for ER-Positive, HER2-Negative Breast Cancer Stratified by Neoadjuvant Endocrine Therapy, Neoadjuvant Chemotherapy, or Upfront Surgery.Annals of surgical oncology · 2026Article
- Feasibility, reliability, and clinical value of genomic assay on pre-therapeutic biopsy for endocrine receptor-positive HER2-negative early breast cancer.Frontiers in oncology · 2026Review
- ASO Author Reflections: Lessons Learned from Neoadjuvant Endocrine Therapy use for Estrogen Receptor Positive Breast Cancer during the Covid-19 Pandemic.Annals of surgical oncology · 2026Article
- Neoadjuvant Endocrine Therapy Use in Estrogen Receptor Positive Breast Cancer: Insights from Practice Shifts During the COVID-19 Pandemic.Annals of surgical oncology · 2026Article
- Survival outcomes after pathologic complete response with neoadjuvant endocrine therapy vs. neoadjuvant chemotherapy: a retrospective national database study.Breast cancer research and treatment · 2025Article
- A pooled analysis evaluating prognostic significance of Residual Cancer Burden in invasive lobular breast cancer.NPJ breast cancer · 2025Article
- Dalpiciclib plus aromatase inhibitor versus neoadjuvant chemotherapy for ER-positive, HER2-negative breast cancer.Frontiers in oncology · 2025Article
- Quantitative Biomarkers, Genomic Assays, and Demographics Associated with Breast-Conserving Surgery Following Neoadjuvant Therapy in Early-Stage, Hormone Receptor-Positive, HER-Negative Breast Cancer.Annals of surgical oncology · 2024Article
- Expanded Indications for Neoadjuvant Endocrine Therapy in Early-Stage Breast Cancer During the COVID-19 Pandemic.Annals of surgical oncology · 2024Article
- Development and validation of a neoadjuvant chemotherapy pathological complete remission model based on Reg IV expression in breast cancer tissues: a clinical retrospective study.Breast cancer (Tokyo, Japan) · 2024Article
- Chemotherapy combined with endocrine neoadjuvant therapy for hormone receptor-positive local advanced breast cancer: a case report and literature review.Frontiers in endocrinology · 2024Review
- Differential response to neoadjuvant endocrine therapy for Black/African American and White women in NCDB.Breast cancer research and treatment · 2024Article
- The Role of Nodes and Nodal Assessment in Diagnosis, Treatment and Prediction in ER+, Node-Positive Breast Cancer.Journal of personalized medicine · 2023Review
- Neoadjuvant Chemotherapy and Endocrine Therapy for Older Patients with Estrogen Receptor Positive Breast Cancer: Comparison of Approaches.Annals of surgical oncology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeoadjuvant chemotherapy (NCT) is considered more effective in downstaging hormone receptor-positive (HR+) breast cancer than neoadjuvant endocrine therapy (NET), particularly in node-positive disease. This study compared breast and axillary response and survival after NCT and NET in HR+ breast cancer.
methodsBased on American College of Surgeons Oncology Group (ACOSOG) Z1031 criteria, women age 50 years or older with cT2-4 HR+ breast cancer who underwent NET or NCT and surgery were identified in the National Cancer Database 2010-2016. Chi-square and logistic regression analysis determined differences between the NCT and NET groups and therapy response, including downstaging and pathologic complete response (pCR, ypT0/is and ypN0).
resultsOf 19,829 patients, 14,025 (70.7%) received NCT and 5804 (29.3%) received NET. The NET patients were older (mean age, 68.9 vs. 60.3; P < 0.001) and had greater comorbidity (1+ Charlson-Deyo score, 21% vs. 16%; P < 0.001). Therapy achieved T downstaging (any) for 58% of the patients with NCT versus 40.5% of the patients with NET, and in-breast pCR was achieved for 9.3% of the NCT versus 1.3% of the NET patients (P < 0.001). Approximately half of the mastectomy procedures could have been potentially avoided for the patients with in-breast pCR (53.6% of the NCT and 43.8% of the NET patients). For the cN+ patients, N downstaging (any) was 29% for the NCT patients versus 18.3% for the NET patients (P < 0.001), and nodal pCR was achieved for 20.3% of the NCT versus 13.5% of the NET patients (P < 0.001). Among those with nodal pCR, axillary lymph node dissection (ALND) still was performed for 56% of the patients after NCT and 45% of the patients after NET.
conclusionsAlthough the response rates after NCT were higher, NET achieved both T and N downstaging and pCR. Neoadjuvant endocrine therapy can be used to de-escalate surgery for patients who cannot tolerate NCT or when chemotherapy may not be effective based on genomic testing.
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