Neoadjuvant therapy for breast cancer has no benefits in routine clinical practice

Our study, with a median follow-up of 11 years, confirms that, for patients with primary operable non-metastatic breast cancer, neoadjuvant chemotherapy failed to improve overall survival. Then added value of neoadjuvant strategy for patient's clinical benefit remains uncertain without demonstrating improvement regarding health related quality of life. Furthermore, we found no difference in the final mastectomy rate between the treatment groups. Of note, it is important to underline that these results are based on an historical cohort. Such bias is inherent to long-term endpoint studies. Never mind our results underline that clinicians should pay caution against the use of neoadjuvant chemotherapy in an unselected population. Then we suggest that the use of neoadjuvant therapy in clinical practice should be carefully discussed before implementation to take into accounts the benefits and risks for the patient. Quality of life could be the cornerstone of this discussion.

Bibliographic Reference:

Le Ray I et al.: "Neoadjuvant therapy for breast cancer has no benefits on overall survival or on the mastectomy rate in routine clinical practice. A population-based study with a median follow-up of 11years using propensity score matching", Eur J Cancer. 2012 Apr 16. [Epub ahead of print

Franck Bonnetain

Biostatistics and Epidemiology Unit, Centre Georges Francois Leclerc (CGFL), Dijon, France