Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

Abstract

Background: The study aims to perform a clinical trial to evaluate the effect of sequencing of systemic therapy on locally advanced breast cancer (LABC). Methods: LABC patients (n = 733) underwent the combination of external beam radiation therapy, chemotherapy, and breast-conservation surgery with difference sequences. Biopsy followed by histopathological examinations was used to assess treatment responses. The primary end point is ipsilateral local recurrence or death. The secondary end points include the incidence and severity of acute and late side effects, cosmesis, and cumulative incidence of regional recurrence and distant metastasis, and survival. The effects of sequence of therapies on the side effects and treatment outcomes were compared. Results: Patients with preoperative systemic treatment, that is, chemotherapy and radiotherapy performed ahead of surgery, had less fibrosis and pain, and showed higher satisfaction regarding the breast conservation. Preoperative systemic treatment also led to better survival of the patients. Conclusions: Preoperative systemic therapy is beneficial to alleviate side effects and improve the breast conservation, treatment outcome, and survival of LABC patients.