Time to surgery after completion of neoadjuvant chemotherapy does not negatively impact recurrence and survival outcomes in breast cancer patients.

Abstract

The effect of time to surgery after completion of neoadjuvant chemotherapy and outcomes in breast cancer patients remains poorly defined. Acceptable time to surgery has frequently been arbitrarily defined as between four to eight weeks. This study aims to ascertain if time to surgery after completion of neoadjuvant chemotherapy impacts disease-free survival (DFS) and overall survival (OS). This single-institution retrospective study included patients who underwent neoadjuvant therapy and subsequent surgery from 2006 to 2017. Demographic, clinicopathological factors, and surgical data from 259 patients were analyzed. 105 patients received surgery within 28 days (group 1). 128 patients received surgery within 29-56 days (group 2), and 26 patients received surgery after 57 days or more (group 3). DFS and OS among the three groups were compared. Age, race, pre-chemotherapy stage, tumor type, grade, hormone receptor status, Her2 status, focality, lymphovascular invasion, radiological response to chemotherapy, type of surgery, pathological response to chemotherapy, and receipt of adjuvant radiotherapy were not significantly different between the three groups. Only receipt of adjuvant chemotherapy was statistically significant (p = 0.0230). DFS and OS between the three groups were not found to be significantly different (p = 0.520 and p = 0.369, respectively). Time to surgery after completion of neoadjuvant chemotherapy did not appear to affect recurrence or survival outcomes. Findings from this study may allow more flexibility and reduce the burden of scheduling patients for surgery within the usual four-to-eight-week window in centers with resource and scheduling constraints.