The Effect of Neoadjuvant vs Adjuvant Chemotherapy on Final Outcome of Patients with Triple Negative Breast Cancer

Background: Triple negative breast cancer (TNBC) accounts for about 10% to 20% of breast cancers, does not respond to endocrine treatment, and is more aggressive. Two chemotherapy methods suggested include neoadjuvant chemotherapy (NAC), performed before surgery, and adjuvant chemotherapy (AC), performed after surgery. In order to determine whether the choice of chemotherapy method has any impact on patients' outcome, the present study aimed to compare the overall survival (OS) and disease-free survival (DFS) of TNBC patients with a 10-year follow-up. Methods: The present study aimed to investigate the effect of neoadjuvant versus adjuvant chemotherapy on the final outcome of patients with TNBC. Women with TNBC stages II and III who referred to the Cancer Research Center of Shahid Beheshti University of Medical Sciences during 2000 and 2020 were included (N = 237) and visited or called by phone to obtain their consent and complete their information. The participants were categorized into 2 groups according to the treatment protocol they received; one group received NAC (N = 85) and the other group received AC (N = 188); patients' age, tumor's grade and stage, lymphovascular invasion (LVI), DFS, and OS were compared between the 2 treatment types. For the statistical analysis, the statistical software IBM SPSS Statistics for Windows, Version 24.0. (IBM Corp) was used. All tests were 2-sided and P values < 0.050 were considered statistically significant. Results: The frequency of pathologies, LVI, and type of surgery was not different between the groups (p = 0.543, p = 0.352, p = 0.935), while the frequency of age categories and tumor grade was significantly different between the groups (p = 0.003, p = 0.001). Ten-year OS and DFS were not different between the groups (p = 0.771, p = 0.506). The Multivariate Cox analysis results showed clinical stage, pathologic grade, age >70, and LVI as significant predictors of death. Conclusion: These results showed that the choice of chemotherapy method, performed before or after surgery, does not influence the 10-year OS and DFS of TNBC patients.