Accurate information about locoregional treatments in breast cancer neoadjuvant systemic therapy (NST) trials is vital to support surgical decision-making and allow meaningful interpretation of long-term oncological outcomes. This systematic review (PROSPERO registration CRD42023470891) aimed to describe the current practice of outcome reporting in NST studies.
A systematic search identified primary research studies published 01/01/2018-08/09/2023 reporting outcomes in patients receiving NST for breast cancer followed by locoregional treatment. Included were randomised controlled trials (RCTs) and non-randomised studies (NRS) with >250 participants reporting at least one locoregional treatment outcome. Outcomes were extracted verbatim and categorised using content analysis. Descriptive statistics were used to summarise results.
Of the 3111 abstracts screened, 137 studies (22 RCTs and 115 NRS) reporting at least one locoregional outcome in 575,531 patients were included.
The 137 studies reported a total of 510 surgical outcomes with a median of 3 (range 1–12) per study. No single outcome was reported in all studies. Type of breast (n = 129, 94.2 %) and axillary (n = 86, 62.8 %) surgery were reported most frequently. Only 34 % (n = 47) studies reported how treatment response was assessed and if/how this informed surgical decision-making. Only a fifth (n = 28) reported outcomes relating to surgical de-escalation.
Only 72 studies (52.6 %) reported any radiation therapy (RT)-related outcome, most frequently whether RT had been received (n = 63/72, 87.5 %).
Current reporting of locoregional treatment outcomes in NST studies is poor, inconsistent and urgently needs to be improved. A core outcome set and reporting guidelines may improve the quality and value of future research.
Michael Jiang, Kerry Avery, Rosina Ahmed, Jana de Boniface, Sanjoy Chatterjee, David Dodwell, Peter Dubsky, Sandy Finestone, Hiroji Iwata, Han-Byoel Lee, Mairead MacKenzie
Anne Meyn, Fiorita Poulakaki, Andrea L. Richardson, Karla Sepulveda, Andrew Spillane,
Alastair M. Thompson, Gustavo Werutsky, Jean L. Wright, Nicholas Zdenkowski, Katherine Cowan, Stuart A. McIntosh, Shelley Potter
Disease Category: Cancer
Disease Name: Breast cancer
Age Range: 16 - 120
Sex: Female
Nature of Intervention: Other
- Systematic review of outcomes measured in trials
- Systematic review
A comprehensive search of PUBMED using terms for ‘breast cancer’ AND ‘neoadjuvant therapy’ was undertaken on September 08, 2023 to identify primary research studies published in English, reporting the outcomes of patients with breast cancer undergoing NST followed by locoregional therapy with surgery and/or radiation therapy with curative intent. The search strategy was adapted from an existing meta-analysis reporting the long-term oncological outcomes of patients treated with NST as it was hypothesised this would also identify relevant studies for inclusion in this review. The full search strategy is summarised in Supplementary. The search was limited to human studies, published in full, in English between January 01, 2018 and September 08, 2023.