Comparison of overall survival after neoadjuvant and adjuvant chemotherapy in patients with early breast cancer with immediate breast reconstruction after mastectomy: A retrospective, matched case‑control study

Abstract

Immediate breast reconstruction after mastectomy combined with chemotherapy is the preferred option for patients with early-stage breast cancer who require both superior clinical and aesthetic outcomes. The present study aimed to determine the survival benefits of neoadjuvant and adjuvant chemotherapy for patients with early-stage breast cancer who have undergone immediate breast reconstruction after mastectomy in Taiwan. The present study compared overall survival (OS) following neoadjuvant or adjuvant chemotherapy in 139 patients with early-stage breast cancer who underwent immediate breast reconstruction after mastectomy. Patient data were used retrospectively as an unmatched cohort. Next, 37 neoadjuvant cases were matched with 37 adjuvant controls through 1:1 age-, clinical stage-, and molecular subtype-matching. OS differences between the cases and controls were determined using Kaplan-Meier survival curve analyses. Here, 77.7 and 81.1% of the unmatched and matched cohort patients were aged <50 years, respectively. Of the matched neoadjuvant cases, 10 (15.6%) reached pathologic complete response after neoadjuvant chemotherapy, whereas 5 (13.5%) neoadjuvant cases succumbed during the study period. The neoadjuvant matched cases demonstrated a significantly poor OS with their adjuvant matched controls (P=0.044); nevertheless, the stratification analysis results demonstrated that the survival differences between the neoadjuvant and the adjuvant controls decreased after matching. Targeted therapy demonstrated the same OS benefits for both the neoadjuvant matched cases and adjuvant matched controls (P=1.000). This study provided matched case-control evidence for the feasibility of neoadjuvant chemotherapy combined with targeted therapy for patients with early-stage breast cancer with immediate breast reconstruction after mastectomy in a Taiwanese female population.

Neoadjuvant Chemotherapy in Patients with HER2-Negative Breast Cancer: A Report from Clinical Breast Cancer Registry of Iran

“… 26 , 27 However, other studies have suggested that the use of NCT does not provide significant survival benefits over traditional adjuvant chemotherapy (ACT). 24 , 28 Moreover, concerns have been raised about the potential for NCT to increase the risk of disease recurrence, particularly in patients with TNBC. 24 , 29 , 30 Studies have shown that various NCT regimens have different effects on the response rate of patients with BC.…”

Curative effect of immediate reconstruction after neoadjuvant chemotherapy for breast cancer: a systematic review and meta-analysis

“…Currently, there are no available RCT researches on the effect of MT+IR following NAC. Previous studies have primarily focused on comparing the outcomes of MT+IR after NAC and adjuvant therapy after MT+IR (27)(28)(29). However, these studies do not provide sufficient information for breast cancer patients who have completed NAC and are preparing for operation.…”