Table 1.
Breast Cancer Patients who Underwent Surgery following Neoadjuvant Chemotherapy, National Cancer Data Base (NCDB), 2010–2014 (n=20,265)a
| All Patients | Receptor Status | p-value | ||||
|---|---|---|---|---|---|---|
| HR+/HER2− | HR+/HER2+ | HR−/HER2+ | HR−/HER2− | |||
| N=20,265 (100%) | N=8,244 (40.7%) | N=3,628 (17.9%) | N=2,147 (10.6%) | N=6,246 (30.8%) | ||
| Age (yr) – Median (IQR) | 52 (44 – 60) | 52 (44 – 61) | 51 (43 – 59.5) | 53 (45 – 61) | 51 (43 – 59) | <0.001 |
| Follow-up (mo) – Median (IQR) b | 35.9 (24.7 – 48.7) | 36.7 (25.2 – 49.4) | 34.5 (24.1 – 47.4) | 33.5 (23.9 – 46.7) | 36.3 (24.7 – 48.8) | <0.001 |
| Response Typec | N=33,162 | N=14,075 | N=6,076 | N=3,172 | N=9,839 | <0.001 |
| Breast+axilla pCR | 6,370 (19.2%) | 1,134 (8.1%) | 1,369 (22.5%) | 1,256 (39.6%) | 2,611 (26.5%) | |
| Breast-only pCR (% cohort | % cN1) | 494 (1.5% | 3.3%) | 155 (1.1% | 2.4%) | 88 (1.4% | 3.0%) | 86 (2.7% | 5.1%) | 165 (1.7% | 4.2%) | |
| Node-only pCR (% cohort | % cN1) | 1,133 (3.4% | 7.5%) | 465 (3.3% | 7.1%) | 225 (3.7% | 7.6%) | 122 (3.8% | 7.3%) | 321 (3.3% | 8.1%) | |
| No change | 9,641 (29.1%) | 4,740 (33.7%) | 1,593 (26.2%) | 579 (18.2%) | 2,729 (27.7%) | |
| Upstage | 2,627 (7.9%) | 1,750 (12.4%) | 353 (5.8%) | 104 (3.3%) | 420 (4.3%) | |
| Race/Ethnicity | <0.001 | |||||
| Non-Hispanic White | 13,866 (68.4%) | 5,773 (70%) | 2,591 (71.4%) | 1,486 (69.2%) | 4,016 (64.3%) | |
| Non-Hispanic Black | 3,252 (16%) | 1,116 (13.5%) | 458 (12.6%) | 293 (13.6%) | 1,385 (22.2%) | |
| Non-Hispanic Other | 915 (4.5%) | 381 (4.6%) | 189 (5.2%) | 117 (5.4%) | 228 (3.7%) | |
| Hispanic | 1,450 (7.2%) | 628 (7.6%) | 267 (7.4%) | 168 (7.8%) | 387 (6.2%) | |
| Histology | <0.001 | |||||
| Ductal | 17,262 (85.2%) | 6,427 (78%) | 3,249 (89.6%) | 1,975 (92%) | 5,611 (89.8%) | |
| Lobular | 1,086 (5.4%) | 903 (11%) | 124 (3.4%) | 16 (0.7%) | 43 (0.7%) | |
| Other | 272 (1.3%) | 53 (0.6%) | 7 (0.2%) | 18 (0.8%) | 194 (3.1%) | |
| Grade | <0.001 | |||||
| 1 | 1,231 (6.1%) | 1,006 (12.2%) | 160 (4.4%) | 21 (1%) | 44 (0.7%) | <0.001 |
| 2 | 6,001 (29.6%) | 3,479 (42.2%) | 1,378 (38%) | 440 (20.5%) | 704 (11.3%) | |
| 3 | 11,414 (56.3%) | 3,132 (38%) | 1,768 (48.7%) | 1,479 (68.9%) | 5,035 (80.6%) | |
| Tumor Size (mm) – Median (IQR) | 27 (17 – 40) | 27 (17 – 40) | 25 (16 – 38) | 28 (18 – 40) | 28 (18 – 40) | <0.001 |
| Clinical T Stage | <0.001 | |||||
| cT1 | 7,174 (35.4%) | 3,071 (37.3%) | 1,477 (40.7%) | 652 (30.4%) | 1,974 (31.6%) | |
| cT2 | 10,460 (51.6%) | 4,143 (50.3%) | 1,747 (48.2%) | 1,122 (52.3%) | 3,448 (55.2%) | |
| cT3 | 2,631 (13%) | 1,030 (12.5%) | 404 (11.1%) | 373 (17.4%) | 824 (13.2%) | |
| Clinical N Stage | <0.001 | |||||
| cN0 | 11,641 (57.4%) | 4,722 (57.3%) | 1,992 (54.9%) | 1,049 (48.9%) | 3,878 (62.1%) | |
| cN1 | 8,624 (42.6%) | 3,522 (42.7%) | 1,636 (45.1%) | 1,098 (51.1%) | 2,368 (37.9%) | |
| ER Status | <0.001 | |||||
| ER+ | 11,397 (56.2%) | 7,912 (96%) | 3,485 (96.1%) | 0 (0%) | 0 (0%) | |
| ER− | 8,868 (43.8%) | 332 (4%) | 143 (3.9%) | 2,147 (100%) | 6,246 (100%) | |
| PR Status | <0.001 | |||||
| PR+ | 9,301 (45.9%) | 6,613 (80.2%) | 2,688 (74.1%) | 0 (0%) | 0 (0%) | |
| PR− | 10,946 (54%) | 1,621 (19.7%) | 932 (25.7%) | 2,147 (100%) | 6,246 (100%) | |
| HER2 Status | <0.001 | |||||
| HER2+ | 5,775 (28.5%) | 0 (0%) | 3,628 (100%) | 2,147 (100%) | 0 (0%) | |
| HER2− | 14,490 (71.5%) | 8,244 (100%) | 0 (0%) | 0 (0%) | 6,246 (100%) | |
| Breast Surgery Type | <0.001 | |||||
| Lumpectomy | 7,698 (38%) | 2,767 (33.6%) | 1,477 (40.7%) | 915 (42.6%) | 2,539 (40.7%) | |
| Mastectomy | 12,557 (62%) | 5,472 (66.4%) | 2,150 (59.3%) | 1,232 (57.4%) | 3,703 (59.3%) | |
| Radiation | ||||||
| Post-lumpectomyd | 7,131 (92.8%) | 2,565 (92.8%) | 1,364 (92.4%) | 840 (91.4%) | 2,362 (93.2%) | 0.76 |
| Post-mastectomye | 5,713 (45.9%) | 2,797 (51.6%) | 923 (43.1%) | 529 (43.4%) | 1,464 (40.0%) | <0.001 |
| Axillary Surgery | <0.001 | |||||
| [1–5] LNs | 10,338 (51%) | 3,913 (47.5%) | 1,846 (50.9%) | 1,031 (48%) | 3,548 (56.8%) | |
| [6–9] LNs | 2,849 (14.1%) | 1,268 (15.4%) | 505 (13.9%) | 278 (12.9%) | 798 (12.8%) | |
| ≥10 LNs | 6,269 (30.9%) | 2,864 (34.7%) | 1,091 (30.1%) | 679 (31.6%) | 1,635 (26.2%) | |
| LNs Examined – Median (IQR) | 5 (2 – 12) | 6 (3 – 13) | 5 (2 – 12) | 5 (2 – 13) | 4 (2 – 10) | <0.001 |
| Positive LNs – Median (IQR) | 1 (1 – 2) | 2 (1 – 2) | 1 (1 – 3) | 1 (1 – 2) | 1 (1 – 2) | <0.001 |
Limited to patients experiencing no stage change, upstage, and overall or anatomically limited (breast or axilla) pathologic complete response.
Median follow-up was estimated for patients diagnosed from 2010–2013 only using reverse KM methods; the log-rank p-value is reported.
Rates for “Response Type” are calculated based on all patients receiving surgery after NACT including those with partial or discordant response. Rates calculated using the study cohort are also included in Supplemental Digital Content, Table 1.
Percentages represent rates of radiation receipt among patients receiving lumpectomy.
Percentages represent rates of radiation receipt among patients receiving mastectomy.
Percentages may not add up to 100 due to rounding or missing values. Supplemental Digital Content, Table 1, contains full table with all examined variables.
ER, estrogen receptor. LN, lymph node. Mo, month. PR, progesterone receptor. Yr, year.