Optimal time to surgery following neoadjuvant chemotherapy and its effect on the survival of patients with breast cancer

Abstract

There is currently an ongoing debate regarding the time to surgery (TS) following neoadjuvant chemotherapy in patients with breast cancer and its effect on survival outcomes. There are three retrospective studies suggesting that the ideal interval is as low as 21 days, 40 days and up to 8 weeks. To date, to the best of our knowledge, there is no consensus available on the ideal time interval to surgery following neoadjuvant chemotherapy in breast cancer patients in the published literature. The present study aimed to evaluate the influence of TS of ≥28 days and its effect on survival outcomes. For this purpose, patients with breast cancer (n=61), during the time period between January, 2012 and December, 2016, were categorised into two cohorts based on the TS following the completion of neoadjuvant chemotherapy. Patients in group 1 (n=8) had a TS of ≤28 days, and those in group 2 had a TS of ≥29 days (n=53). Overall survival and locoregional recurrence-free survival were compared between both groups. A total of 61 patients with breast cancer who had received neoadjuvant chemotherapy followed by surgery and fulfilled the inclusion criteria were included in the study. The median follow-up time was 29 months. There was no observed association between age, tumour biology, the chemotherapy regimen, type of surgery, pathological response and the TS. The mortality rates were zero in group 1 and 18.9% in group 2. Locoregional recurrence rates were zero in group 1 and 9.4% in group 2. On the whole, the findings of the present study support a shorter duration (≤28 days) of TS following neoadjuvant chemotherapy for optimal survival outcomes.