Trial reportAnnals of surgical oncology2023
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.
Trial report in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Surgical outcomes of neoadjuvant endocrine treatment in early breast cancer: meta-analysis.BJS open · 2024Pooled it
- A Non-Inferior Randomized Trial of Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Premenopausal Patients With Hormone-Responsive and HER2-Negative Lymph Node-Negative Breast Cancer.Cancer control : journal of the Moffitt Cancer CenterTrial
- Lack of Utility of Ki-67 in Axillary Surgical Planning and Prognostication after Neoadjuvant Chemotherapy for Node-Positive Breast Cancer.Annals of surgical oncology · 2026Article
- 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
- Axillary Management after Neoadjuvant Endocrine Therapy (NET).Annals of surgical oncology · 2026Article
- ASO Author Reflections: Semi-Structured Surgeon Interviews Regarding Axillary Management After Neoadjuvant Endocrine Therapy: Could They Lead to Consensus Guidelines?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
- Neoadjuvant Endocrine Therapy Use in Estrogen Receptor Positive Breast Cancer: Insights from Practice Shifts During the COVID-19 Pandemic.Annals of surgical oncology · 2026Article
- Significance of Residual Nodal Disease in Clinically Node-Negative Breast Cancer After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- ASO Author Reflections: De-escalating Axillary Surgery in Patients with Clinically Node-Negative Breast Cancer After Neoadjuvant Chemotherapy.Annals of surgical oncology · 2025Article
- Nodal Response and Survival After Neoadjuvant Endocrine Therapy in Hormone Receptor-Positive Breast Cancer: 20-Year Experience from a Single Institution.Annals of surgical oncology · 2024Article
- Identifying Factors Predicting Margin Status After Mastectomy.Annals of surgical oncology · 2024Article
- Breast surgery after neoadjuvant systemic therapy.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThe ACOSOG Z1031 trial addressed the ability of three neoadjuvant aromatase inhibitors (NAIs) to reduce residual disease (cohort A) and to assess whether switching to neoadjuvant chemotherapy (NCT) after 4 weeks of receiving NAI with Ki67 greater than 10% increases pathologic complete response (pCR) in postmenopausal women with estrogen receptor-enriched (Allred score 6-8) breast cancer (BC).
methodsThe study enrolled 622 women with clinical stage 2 or 3 estrogen receptor-positive (ER+) BC. Cohort A comprised 377 patients, and cohort B had 245 patients. The analysis cohort consisted of 509 patients after exclusion of patients who did not meet the trial eligibility criteria, switched to NCT or surgery due to 4-week Ki67 greater than 10%, or withdrew before surgery. Distribution of time to local-regional recurrence (LRR) was estimated using the competing-risk approach, in which distant recurrence and second primaries were considered to be competing-risk events. Patients who died without LRR, distant recurrence, or a second primary were censored at the last evaluation.
resultsOf the 509 patients, 342 (67.2%) had breast-conserving surgery (BCS). Of 221 patients thought to require mastectomy at presentation, 50% were able to have BCS. Five (1%) patients had no residual disease in the breast or nodes at surgery. Among 382 women alive at this writing, 90% have been followed longer than 5 years. The 5-year cumulative incidence rate for LRR is estimated to be 1.53% (95% confidence interval 0.7-3.0%).
conclusionsRarely does NAI result in pCR for patients with stage 2 or 3 ER+ BC. However, a significant proportion will have downstaged to allow for BCS. Local-regional recurrence after surgery is uncommon (1.5% at 5 years), supporting the use of BCS after NAI.
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