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Fasano GA, Bayard S, Chen Y, Varella L, Cigler T, Bensenhaver J, Simmons R, Swistel A, Marti J, Moore A, Andreopoulou E, Ng J, Brandmaier A, Formenti S, Ali H, Davis M, Newman L. Benefit of adjuvant chemotherapy in node-negative T1a versus T1b and T1c triple-negative breast cancer. Breast Cancer Res Treat 2022; 192:163-173. [PMID: 35022867 DOI: 10.1007/s10549-021-06481-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/03/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE National comprehensive cancer network guidelines recommend delivery of adjuvant chemotherapy in node-negative triple-negative breast cancer (TNBC) if the tumor is > 1 cm and consideration of adjuvant chemotherapy for T1b but not T1a disease. These recommendations are based upon sparse data on the role of adjuvant chemotherapy in T1a and T1b node-negative TNBC. Our objective was to clarify the benefits of chemotherapy for patients with T1N0 TNBC, stratified by tumor size. METHODS We performed a retrospective analysis of survival outcomes of TNBC patients at two academic institutions in the United States from 1999 to 2018. Primary tumor size, histology, and nodal status were based upon surgical pathology. The Kaplan-Meier plot and 5-year unadjusted survival probability were evaluated. RESULTS Among 282 T1N0 TNBC cases, the status of adjuvant chemotherapy was known for 258. Mean follow-up was 5.3 years. Adjuvant chemotherapy was delivered to 30.5% of T1a, 64.7% T1b, and 83.9% T1c (p < 0.0001). On multivariable analysis, factors associated with delivery of adjuvant chemotherapy were tumor size and grade 3 disease. Improved overall survival was associated with use of chemotherapy in patients with T1c disease (93.2% vs. 75.2% p = 0.008) but not T1a (100% vs. 100% p = 0.3778) or T1b (100% vs. 95.8% p = 0.2362) disease. CONCLUSION Our data support current guidelines indicating benefit from adjuvant chemotherapy in node-negative TNBC associated with T1c tumors but excellent outcomes were observed in the cases of T1a and T1b disease, regardless of whether adjuvant chemotherapy was delivered.
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Affiliation(s)
- Genevieve A Fasano
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Solange Bayard
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Yalei Chen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Leticia Varella
- Department of Medical Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Tessa Cigler
- Department of Medical Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | | | - Rache Simmons
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Alexander Swistel
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Jennifer Marti
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Anne Moore
- Department of Medical Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Eleni Andreopoulou
- Department of Medical Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - John Ng
- Department of Radiation Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Andrew Brandmaier
- Department of Radiation Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Silvia Formenti
- Department of Radiation Oncology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Haythem Ali
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Melissa Davis
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - Lisa Newman
- Department of Surgery, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA.
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