TY - JOUR
T1 - Fewer Reoperations After Lumpectomy for Breast Cancer with Neoadjuvant Rather than Adjuvant Chemotherapy
T2 - A Report from the National Cancer Database
AU - Landercasper, Jeffrey
AU - Bennie, Barbara
AU - Parsons, Benjamin M.
AU - Dietrich, Leah L.
AU - Greenberg, Caprice C.
AU - Wilke, Lee G.
AU - Linebarger, Jared H.
N1 - Funding Information:
The authors thank Choua Vang for her assistance with manuscript preparation, Jacob Barnes and Amy Kleinvachter for statistical assistance, James Burmester for critical review of the manuscript, and the Gundersen Medical Foundation, the Norma J. Vinger Center for Breast Care, and the University of Wisconsin La Crosse for financial and statistical support.
Publisher Copyright:
© 2017, The Author(s).
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: Reoperations occur frequently after initial lumpectomy for breast cancer. The authors hypothesized that the receipt of neoadjuvant chemotherapy (NAC) is associated with fewer reoperations. Methods: The association between timing of chemotherapy and reoperation rates (ROR) after lumpectomy was investigated for patients with stages 1–3 breast cancer in the National Cancer Database (NCDB) from 2010 to 2013 by multivariable logistic regression modeling. Then propensity score-matching was performed. Results: The unadjusted ROR for 71,627 stages 1–3 patients was 11.4% for those who had NAC compared with 20.3% for those who had postoperative chemotherapy (p < 0.001) (odds ratio [OR] 0.53; 95% confidence interval [CI] 0.49–0.57; p < 0.001). The ORs for the reoperations performed for patients with stages 1, 2, and 3 cancers who received NAC were respectively 0.65 (95% CI 0.56–0.75), 0.50 (95% CI 0.45–0.56), and 0.27 (95% CI 0.19–0.38) The p values for all were lower than 0.001. Conclusion: For a population of patients receiving chemotherapy, the receipt of chemotherapy before instead of after surgery was associated with fewer reoperations after initial lumpectomy for breast cancer.
AB - Background: Reoperations occur frequently after initial lumpectomy for breast cancer. The authors hypothesized that the receipt of neoadjuvant chemotherapy (NAC) is associated with fewer reoperations. Methods: The association between timing of chemotherapy and reoperation rates (ROR) after lumpectomy was investigated for patients with stages 1–3 breast cancer in the National Cancer Database (NCDB) from 2010 to 2013 by multivariable logistic regression modeling. Then propensity score-matching was performed. Results: The unadjusted ROR for 71,627 stages 1–3 patients was 11.4% for those who had NAC compared with 20.3% for those who had postoperative chemotherapy (p < 0.001) (odds ratio [OR] 0.53; 95% confidence interval [CI] 0.49–0.57; p < 0.001). The ORs for the reoperations performed for patients with stages 1, 2, and 3 cancers who received NAC were respectively 0.65 (95% CI 0.56–0.75), 0.50 (95% CI 0.45–0.56), and 0.27 (95% CI 0.19–0.38) The p values for all were lower than 0.001. Conclusion: For a population of patients receiving chemotherapy, the receipt of chemotherapy before instead of after surgery was associated with fewer reoperations after initial lumpectomy for breast cancer.
UR - http://www.scopus.com/inward/record.url?scp=85008430131&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85008430131&partnerID=8YFLogxK
U2 - 10.1245/s10434-016-5760-8
DO - 10.1245/s10434-016-5760-8
M3 - Article
C2 - 28062931
AN - SCOPUS:85008430131
SN - 1068-9265
VL - 24
SP - 1507
EP - 1515
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 6
ER -
