Introduction Our retrospective study analyzed the adjuvant treatment decision for localized intermediate risk breast cancer as well as the parameters leading to protocol de-escalation and It’s impact on outcome.
Methods A retrospective study gathering 127 patients with localized (pT1–3pN1 or pT2–3pN0) luminal breast cancers; We analyzed the protocol decision and the parameters leading to de-escalation as well as the therapeutic results.
Results Median age was 52 years and 47% were pre-menopausal. One third of the tumors were pN0, mean tumor size (pT) was 28 mm, and grade III in 27.4% of cases. Most of the tumors (66%) were of Luminal B and the mean ki67 was 26%.Adjuvant protocol was chemotherapy for 119 patients, sequential in 80.3% of cases and Docetaxel-Cyclophosphamide(TC) in 13.4% of cases.Twenty-four cases were reviewed by the medical comittee, and a therapeutic de-escalation was decided for 12 patients among them, based on TC(6 patients) and hormone therapy for 6 patients.The patients characteristics are resumed in table 1.Concerning toxicity, we observed a higher rate of neutropenia (47.5% vs 11.8% p=0.04) and febrile neutropenia G3–4 (20.6% vs. 0% p=0.02)with sequential chemotherapy. With a median follow-up of 51 months, overall survival was 94% at 5 years.The choice of adjuvant treatment didn’t significantly influence overall survival.
Conclusion/Implications De-escalation of adjuvant therapy in patients with intermediate risk localized breast cancer didn’t impair overall survival.
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