Use of neoadjuvant versus adjuvant chemotherapy for hormone receptor-positive breast cancer: a National Cancer Database (NCDB) study

Introduction: Neoadjuvant chemotherapy (NAC) is a well established therapeutic option for patients with locally advanced disease often allows downstaging and facilitation of breast conserving therapy. With the evolution of the treatment regimen is more targeted and better awareness of the results for respondents was significant, the use of NAC has been expanded, especially for triple negative and HER2-positive breast cancer (HER2 +).

In this study, we explore the utility of neoadjuvant chemotherapy for hormone receptor-negative HER2-positive (HR + HER2) patients.
Methods: Patients with HR + HER2 breast cancer is treated with chemotherapy before or after surgery were identified from 2010 to 2015 in NCDB. Multivariable regression models adjusted for covariates was used to determine the association of these groups.


Results: Among 134 574 patients (phase 2A clinical, 64%; 2B, 21%, 3, 15%), 105 324 (78%) had adjuvant chemotherapy (AC) and 29,250 (22%) received NAC. The use of NAC increased over time (2010-2015; 13.2 to 19.4% and PR = 1.34 for 2015; p <0.0001). Patients were more likely to receive NAC with CT3, CT4, and diseases CN +. Patients tend to receive NAC were age ≥ 50, lobular carcinoma, increasing Charlson-Deyo score, and government insurance. complete response (pCR) was recorded in 8.3% of patients with NAC. downstaging axillary occurred in 21% of patients, and predictors included age <50 years, black race, class of poorly differentiated, invasive ductal histology, and either ER or PR negative.


Conclusion:
NAC use among patients with HR + HER2 breast cancer has evolved over time and offer downstaging disease for some patients with pCR look at just a fraction, but downstaging of the axilla in 21%. Further analysis is required to determine a subgroup of patients with HR + HER2 disease who benefit from this approach.

 Use of neoadjuvant versus adjuvant chemotherapy for hormone receptor-positive breast cancer: a National Cancer Database (NCDB) study
Use of neoadjuvant versus adjuvant chemotherapy for hormone receptor-positive breast cancer: a National Cancer Database (NCDB) study

Influence of Metabolic Syndrome at Risk of Breast Cancer: A Nationwide Study Analyzing data from the Korea National Health Care Insurance

Background: To determine the effect of metabolic syndrome and components on the risk of breast cancer.


METHODS: Retrospective cohort study analyzing data nationwide 13,377,349 women older than 19 years of National Insurance Health Care Korea do. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence interval (CI) of the risk of breast cancer.
Results: The presence of metabolic syndrome decreased risk of all types of breast cancer in all subjects (HR: 0.954; 95% CI: 0.939 to 0.970).

In women aged ≤ 50 years, metabolic syndrome decreased risk of all types of breast cancer, the findings were the same for all groups of subjects (HR: 0.915; 95% CI: 0.892 to .939). In women aged> 50 years, metabolic syndrome increases the risk of all types of breast cancer (HR: 1.146; 95% CI: 1.123 to 1.170), especially in the age group over 55 years. In women aged> 50 years, HR increases as the number of metabolic syndrome components increased, while HR decreased due to the number of metabolic syndrome components increased in women aged ≤ 50 years.

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Conclusion: The presence of metabolic syndrome increases the risk of breast cancer in postmenopausal women, but a decreased risk in premenopausal women. Each component of the metabolic syndrome plays the same role in breast cancer risk for metabolic syndrome and their effect becomes stronger as the number of components increases.