Evidence map›Paper›PMID 40849380›Full record

ArticleAnnals of surgical oncology2025

Impact of Time to Surgery Post Neoadjuvant Chemotherapy on Breast Cancer Outcomes: A Retrospective Study of Patients Enrolled in the I-SPY 2 Clinical Trial.

Julie Van Hassel, Katrina Dimitroff, Christina Yau, Rita Mukhtar, Judy C Boughey, Velle Ladores, Marissa M Howard-McNatt, Nora Jaskowiak, Jane Perlmutter, Angela DeMichele and 23 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Julie Van HasselColumbia University Irving Medical Center, Division of Breast, Melanoma and Soft Tissue Surgery, New York, NY, USA.
Katrina DimitroffUniversity of California San Francisco, San Francisco, CA, USA.
Christina YauUniversity of California San Francisco, San Francisco, CA, USA.
Rita MukhtarUniversity of California San Francisco, San Francisco, CA, USA.
Judy C BougheyMayo Clinic, Rochester, MN, USA.
Velle LadoresUniversity of California San Francisco, San Francisco, CA, USA.
Marissa M Howard-McNattWake Forest University, Winston-Salem, NC, USA.
Nora JaskowiakUniversity of Chicago, Chicago, IL, USA.
Jane PerlmutterGemini Group Consultancy, Ann Arbor, MI, USA.
Angela DeMicheleUniversity of Pennsylvania, Pennsylvania, PA, USA.
Douglas YeeUniversity of Minnesota, Minneapolis, MN, USA.
Nola HyltonUniversity of California San Francisco, San Francisco, CA, USA.
W Fraser SymmansMD Anderson Cancer Center, Houston, TX, USA.
Laura Van't VeerUniversity of California San Francisco, San Francisco, CA, USA.
Hope RugoUniversity of California San Francisco, San Francisco, CA, USA.
Laura J EssermanUniversity of California San Francisco, San Francisco, CA, USA.
Rebecca ShatskyUniversity of California San Diego, San Diego, CA, USA.
Claudine IsaacsGeorgetown University, Washington, DC, USA.
Henry KuererMD Anderson Cancer Center, Houston, TX, USA.
Anne M WallaceUniversity of California San Diego, San Diego, CA, USA.
Nicolas PrionasUniversity of California San Francisco, San Francisco, CA, USA.
Jennifer TsengCity of Hope, Duarte, CA, USA.
Chantal R ReynaLoyola University Medical Center, Chicago, IL, USA.
Neil TaunkUniversity of Pennsylvania, Pennsylvania, PA, USA.
Susan KesmodelUniversity of Miami, Miami, FL, USA.
Marie C LeeMoffitt Cancer Center, Tampa, FL, USA.
Jana FoxMontefiore Einstein, New York, NY, USA.
Mara A PiltinMayo Clinic, Rochester, MN, USA.
Julia TchouUniversity of Pennsylvania, Pennsylvania, PA, USA.
Cletus A ArcieroEmory University, Atlanta, GA, USA.
Lauren M PostlewaitEmory University, Atlanta, GA, USA.
Candice SauderUniversity of California Davis, Davis, CA, USA.
Roshni RaoColumbia University Irving Medical Center, Division of Breast, Melanoma and Soft Tissue Surgery, New York, NY, USA. rr3181@cumc.columbia.edu.

Funding

The I SPY 2.2 TRIAL: Evolving to Imaging and Molecular Biomarker Response Directed Adaptive Sequential Treatment to Optimize Breast Cancer OutcomesP01CA210961 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Nola M. Hylton-Watson · 2017 to 2026
$22.9M
NCI NIH HHS P01 CA210961NCI of the National Institutes of Health (NIH) P01CA210961
6 · The paper itself

Abstract

backgroundNeoadjuvant chemotherapy (NAC) is widely used to treat high-risk breast cancer. However, the optimal time to surgery (TTS) following NAC remains undefined. This study investigates the impact of TTS on oncologic outcomes using the I-SPY 2 Trial cohort.

methodsA retrospective analysis of 1877 patients with breast cancer enrolled in the I-SPY 2 Trial was performed. Patients were grouped by TTS post-NAC: 1-4 weeks, 5 weeks, 6-8 weeks, and 9 + weeks. Baseline demographic, clinical, imaging, and treatment response data were collected. Event-free survival (EFS) and local recurrence-free interval (LRFI) were evaluated using Kaplan-Meier analyses and Cox models. Subgroup analyses were performed by tumor receptor subtypes (hormone receptor [HR]+ human epidermal growth factor receptor 2 [HER2]-, HER2 +, and triple-negative breast cancer [TNBC]) and residual cancer burden (RCB) class.

resultsAmong 1877 patients, 526 (28.0%) underwent surgery between 1-4 weeks, 425 (22.6%) at 5 weeks, 490 (26.1%) between 6-8 weeks, and 436 (23.2%) at 9+ weeks post-NAC. Prolonged TTS was associated with worse 5-year EFS and LRFI on Kaplan-Meier analysis (p < 0.001 for both). Delays particularly affected outcomes in patients with HR+/HER2- and TNBC tumors. In patients with RCB class II/III, a TTS of 9+ weeks was independently associated with worse EFS (hazard ratio [HR] 2.04, p = 0.001) and LRFI (HR 2.77, p = 0.005). Conversely, in patients with a pathologic complete response/RCB class I, delayed surgery did not significantly impact outcomes.

conclusionsTTS of 9+ weeks following NAC is independently associated with worse oncologic outcomes, especially in patients with TNBC and HR+/HER2- tumors and high residual disease.

Indexed as

Breast NeoplasmsMastectomyNeoplasm Recurrence, LocalTime-to-TreatmentTriple Negative Breast NeoplasmsAdaptive Clinical Trials as TopicAdultChemotherapy, AdjuvantClinical Trials, Phase II as TopicErb-b2 Receptor Tyrosine KinasesFemaleHumansKaplan-Meier EstimateMiddle AgedMulticenter Studies as TopicNeoadjuvant TherapyERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneBreast cancerNeoadjuvant chemotherapyOncologic outcomesResidual cancer burdenTime to surgery

Identifiers

PMID40849380
PMCPMC13262329

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.