Table 2.
Adjusted Overall Survival, Women with cT1-4c, cN1-3, HR+ Invasive Lobular Carcinoma Who Received Neoadjuvant Endocrine Therapy or Chemotherapy, National Cancer Data Base, 2004-2014 (N=4478)
| HR (95% CI) | P-Value | Overall P-Value | |
|---|---|---|---|
| Treatment group | 0.10 | ||
| Neoadjuvant chemotherapy | REF | ||
| Neoadjuvant endocrine therapy | 0.84 (0.68 - 1.03) | 0.10 | |
| Adjuvant therapya | <0.001 | ||
| No | REF | ||
| Yes | 0.60 (0.50-0.72) | <0.001 | |
| Age (years) | <0.001 | ||
| ≥50 | REF | ||
| <50 | 0.76(0.65-0.88) | <0.001 | |
| Race | 0.05 | ||
| White | REF | ||
| Black | 1.17 (0.95 - 1.45) | 0.14 | |
| Other | 0.61 (0.37 - 1.03) | 0.06 | |
| Ethnicity | 0.01 | ||
| Hispanic | REF | ||
| Non-Hispanic | 1.67 (1.12-2.48) | 0.01 | |
| Charlson/Deyo comorbidity score | 0.009 | ||
| 0 | REF | ||
| 1 | 1.16 (0.93 - 1.43) | 0.18 | |
| ≥2 | 1.71 (1.19-2.44) | 0.003 | |
| Pathological T classification | <0.001 | ||
| 1 | REF | ||
| 0 | 1.78 (1.11 - 2.86) | 0.02 | |
| 2 | 1.33 (1.07 - 1.65) | 0.010 | |
| 3 | 1.54 (1.24-1.92) | <0.001 | |
| 4 | 2.01 (1.47-2.75) | <0.001 | |
| X | 1.30 (0.82-2.04) | 0.26 | |
| Pathological N classification | <0.001 | ||
| 0 | 0.87 (0.65 - 1.15) | 0.33 | |
| 1 | REF | ||
| 2 | 1.51 (1.25 - 1.83) | <0.001 | |
| 3 | 2.75 (2.28-3.32) | <0.001 | |
| X | 0.60 (0.38-0.95) | 0.03 | |
| Grade | <0.001 | ||
| 1 | REF | ||
| 2 | 1.30 (1.08 - 1.57) | 0.006 | |
| 3 | 1.69 (1.35-2.10) | <0.001 | |
| Surgery type | 0.001 | ||
| Lumpectomy | REF | ||
| Mastectomy | 1.37 (1.13 - 1.67) | 0.001 | |
| Treated with radiationb | 0.003 | ||
| No | REF | ||
| Yes | 0.77 (0.65-0.92) | 0.003 | |
| Income level ($) | 0.87 | ||
| <$35,000 | REF | ||
| ≥$35,000 | 0.99 (0.82 - 1.18) | 0.87 | |
| Insurance status | <0.001 | ||
| Private | REF | ||
| Government | 1.39 (1.20 - 1.61) | <0.001 | |
| Not Insured | 1.45 (0.99-2.12) | 0.05 | |
| Education level | 0.06 | ||
| ≤80% High School Graduation Rate | REF | ||
| >80% High School Graduation Rate | 0.85 (0.72 - 1.01) | 0.06 | |
| Facility type | 0.01 | ||
| Academic | REF | ||
| Integrated Network | 1.36 (1.08 - 1.71) | 0.009 | |
| Comprehensive | 1.26 (1.07 - 1.48) | 0.005 | |
| Community | 1.06 (0.81 - 1.39) | 0.66 | |
| Facility location | 0.14 | ||
| South | REF | ||
| Midwest | 1.12 (0.93 - 1.34) | 0.24 | |
| Northeast | 0.97 (0.80 - 1.19) | 0.79 | |
| West | 0.85 (0.67 - 1.07) | 0.16 | |
Hazard ratios, confidence intervals, and p-values are from a Cox proportional hazards model, stratified by year of diagnosis (grouped as 2004-2009 and 2010-2014). A robust sandwich covariance estimator was used to account for correlation of patients treated at the same facility.
Receipt of complementary adjuvant systemic therapy that was not received in neoadjuvant setting (i.e., ACT for patients receiving NET, AET for patients receiving NACT).
Interaction with type of breast surgery received was tested and not significant.
HR: Hazard ratio. CI: Confidence interval.