Current decisions on neoadjuvant chemotherapy for early breast cancer: Experts’ experiences in the Netherlands

P.E.R. Spronk (Corresponding Author), K.M. de Ligt, A.C.M. van Bommel, S. Siesling, C.H. Smorenburg, M.T.F.D. Vrancken Peeters, On behalf of the NABON Breast Cancer Audit

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Purpose: To evaluate the opinion of surgical and medical oncologists on neoadjuvant chemotherapy (NAC) for early breast cancer.

Methods: Surgical and medical oncologists (N = 292) participating in breast cancer care in the Netherlands were invited for a 20-question survey on the influence of patient, disease, and management related factors on their decisions towards NAC.

Results: A total of 138 surgical and medical oncologists from 64 out of 89 different Dutch hospitals completed the survey. NAC was recommended for locally advanced breast cancer (94%) and for downstaging to enable breast conserving surgery (BCS) (75%). Despite willingness to downstage, 64% of clinicians routinely recommended NAC when systemic therapy was indicated preoperatively. Reported reasons to refrain from NAC are comorbidities (68%), age >70 years (52%), and WHO-performance status ≥2 (93%). Opinions on NAC and surgical management were inconclusive; while 75% recommends NAC to enable BCS, some stated that BCS after NAC increases the risk of a non-radical resection (21%), surgical complications (9%) and recurrence of disease (5%).

Conclusion: This article emphasizes the need for more consensus among specialists on the indications for NAC in early BC patients. Unambiguous and evidence-based treatment information could improve doctor-patient communication, supporting the patient in chemotherapy timing decision-making.

Original languageEnglish
Pages (from-to)2111-2115
Number of pages5
JournalPatient education and counseling
Issue number12
Publication statusPublished - Dec 2018


  • Early breast cancer
  • Experts’ opinions
  • Neoadjuvant chemotherapy (NAC)
  • 22/4 OA procedure

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