- Treatment with neoadjuvant chemotherapy (NACT) is associated with poorer distant recurrence-free survival (DRFS) than treatment with adjuvant chemotherapy (ACT) in black, but not white, women with stage II-III breast cancer (BC).
Why this matters
- Results counter widespread practice of giving black women NACT over ACT because NACT is thought to decrease tumor burden and improve surgical outcome.
- A larger observational study is needed.
- Single-center retrospective cohort of 807 patients with stage II-III BC (65% black; 35% white).
- Cohort was evaluated for association among race, DRFS, and type of chemotherapy (NACT vs ACT).
- Funding: NIH; Albert Einstein College of Medicine.
- Across the entire cohort, worse DRFS was associated with stage III disease (P<.0001 and age years not black race use of nact triple-negative disease estrogen receptor-negative status>
- Stratifying by black race, NACT was associated with worse DRFS than ACT (HR, 2.7; P<.0001>
- Stratifying by white race, NACT was not associated with worse DRFS than ACT (HR, 1.29; P=.36).
- Retrospective, observational design.
- Single-center study.
- Limited data on confounders.