Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands

P.E.R. Spronk, A.C.M. van Bommel, S. Siesling, M.J.T. Baas-Vrancken Peeters, C.H. Smorenburg

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Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands P.E.R. Spronk1, A.C.M. Van Bommel1, S. Siesling2,3, M.J.T. Baas- Vrancken Peeters4, C.H. Smorenburg5. 1Leiden University Medical Centre, Surgery, Leiden, Netherlands; 2Comprehensive Cancer Centre the Netherlands IKNL, Epidemiology, Utrecht, Netherlands; 3University of Twente, MIRA Biomedical science and Technical Medicine, Twente, Netherlands; 4Netherlands Cancer Institute/Antoni van Leeuwenhoek, Surgery, Amsterdam, Netherlands; 5Netherlands Cancer Institute/Antoni van Leeuwenhoek, Medical Oncology, Amsterdam, Netherlands Background: Neoadjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (LABC). The aim of this study is to examine the use of NAC for LABC in all Dutch hospitals participating in breast cancer care and to assess what patient, tumour and hospital characteristics influence its use. Material and Methods: Data were derived from the national multidisciplinary NABON Breast Cancer Audit (NBCA), regarding all women aged >18 years and newly diagnosed with LABC from January 2011 to September 2013. Multivariable logistic regression was used to assess the association between the use of NAC and patient, tumour and hospital related factors. Results: Of 1419 woman diagnosed with LABC, 70% were treated with NAC. This percentage varied from 12.5% to 90% between hospitals and did not increase over time. Factors associated with the use of NAC included young age, large tumour size, more advanced nodal disease and triple negative or hormone-receptor negative tumours. Also patients treated in hospitals with a multidisciplinary preoperative work-up and participation in neoadjuvant studies were more likely to receive NAC. However, considerable variation between hospitals remained after casemix correction. Table 1. Multivariable odds ratios (ORs) for receipt of NAC among 1419 stage III patients 2011 through 2013 OR 95% CI P-value Age 0.000 <40 0.92 0.44−1.94 40−49 ref. 50−59 0.67 0.41−1.09 60−69 0.51 0.31−0.84 70 0.03 0.02−0.05 Histologic subtype 0.145 ductal ref. lobular 0.58 0.34−0.98 both 1.19 0.33−4.29 other 0.55 0.20−1.53 Multifocal 0.997 yes ref. no 1.00 0.67−1.50 Tumor size 0.000 5 cm ref. >5 cm 5.68 2.34−13.79 Clinical nodal status 0.000 cNx/N0 ref. cN1 1.32 0.86−2.04 cN2 2.93 1.18−7.29 cN3 10.28 4.18−25.25 Receptor status 0.000 Triple negative 2.35 1.40−3.93 HR−, Her2+ 3.37 1.67−6.78 HR+, Her2+ 0.91 0.51−1.60 HR+, Her2− ref. Type of surgery 0.026 Breast conservation therapy 2.05 1.09−3.84 Mastectomy ref. Multidisciplinary team 0.021 Yes 1.98 1.11−3.53 No ref. Type of hospital 0.569 General 1.20 0.73−1.98 Top clinical ref. Academic 1.50 0.64−3.47 Hospital surgical volume 0.729 <100 1.19 0.69−2.06 100–200 ref. >200 1.27 0.70−2.31 Study participation 0.005 Yes 1.80 1.20−2.70 No ref. Conclusions: There is considerable variation in the use of NAC for LABC in the Netherlands. Although various patient, tumor and institutional factors are associated with the use of NAC in LABC, these can only explain part of the observed variation in treatment patterns between hospitals.
Original languageEnglish
PagesS93-S93
Number of pages1
Publication statusPublished - 11 Mar 2016
Event10th European Breast Cancer Conference (EBCC-10) : Multidisciplinary Innovation in Breast Cancer Care - RAI Amsterdam, Amsterdam, Netherlands
Duration: 9 Mar 201611 Mar 2016
Conference number: 10

Conference

Conference10th European Breast Cancer Conference (EBCC-10)
Abbreviated titleEBCC
CountryNetherlands
CityAmsterdam
Period9/03/1611/03/16

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Netherlands
Breast Neoplasms
Drug Therapy
Neoplasms
Medical Oncology
Epidemiology
Breast
Therapeutics
Logistic Models
Odds Ratio
Medicine
Hormones

Keywords

  • METIS-316254
  • IR-100066

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Spronk, P. E. R., van Bommel, A. C. M., Siesling, S., Baas-Vrancken Peeters, M. J. T., & Smorenburg, C. H. (2016). Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands. S93-S93. Abstract from 10th European Breast Cancer Conference (EBCC-10) , Amsterdam, Netherlands.
Spronk, P.E.R. ; van Bommel, A.C.M. ; Siesling, S. ; Baas-Vrancken Peeters, M.J.T. ; Smorenburg, C.H. / Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands. Abstract from 10th European Breast Cancer Conference (EBCC-10) , Amsterdam, Netherlands.1 p.
@conference{6f7e6e3282aa4587a1e56cdd42afe486,
title = "Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands",
abstract = "Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands P.E.R. Spronk1, A.C.M. Van Bommel1, S. Siesling2,3, M.J.T. Baas- Vrancken Peeters4, C.H. Smorenburg5. 1Leiden University Medical Centre, Surgery, Leiden, Netherlands; 2Comprehensive Cancer Centre the Netherlands IKNL, Epidemiology, Utrecht, Netherlands; 3University of Twente, MIRA Biomedical science and Technical Medicine, Twente, Netherlands; 4Netherlands Cancer Institute/Antoni van Leeuwenhoek, Surgery, Amsterdam, Netherlands; 5Netherlands Cancer Institute/Antoni van Leeuwenhoek, Medical Oncology, Amsterdam, Netherlands Background: Neoadjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (LABC). The aim of this study is to examine the use of NAC for LABC in all Dutch hospitals participating in breast cancer care and to assess what patient, tumour and hospital characteristics influence its use. Material and Methods: Data were derived from the national multidisciplinary NABON Breast Cancer Audit (NBCA), regarding all women aged >18 years and newly diagnosed with LABC from January 2011 to September 2013. Multivariable logistic regression was used to assess the association between the use of NAC and patient, tumour and hospital related factors. Results: Of 1419 woman diagnosed with LABC, 70{\%} were treated with NAC. This percentage varied from 12.5{\%} to 90{\%} between hospitals and did not increase over time. Factors associated with the use of NAC included young age, large tumour size, more advanced nodal disease and triple negative or hormone-receptor negative tumours. Also patients treated in hospitals with a multidisciplinary preoperative work-up and participation in neoadjuvant studies were more likely to receive NAC. However, considerable variation between hospitals remained after casemix correction. Table 1. Multivariable odds ratios (ORs) for receipt of NAC among 1419 stage III patients 2011 through 2013 OR 95{\%} CI P-value Age 0.000 <40 0.92 0.44−1.94 40−49 ref. 50−59 0.67 0.41−1.09 60−69 0.51 0.31−0.84 70 0.03 0.02−0.05 Histologic subtype 0.145 ductal ref. lobular 0.58 0.34−0.98 both 1.19 0.33−4.29 other 0.55 0.20−1.53 Multifocal 0.997 yes ref. no 1.00 0.67−1.50 Tumor size 0.000 5 cm ref. >5 cm 5.68 2.34−13.79 Clinical nodal status 0.000 cNx/N0 ref. cN1 1.32 0.86−2.04 cN2 2.93 1.18−7.29 cN3 10.28 4.18−25.25 Receptor status 0.000 Triple negative 2.35 1.40−3.93 HR−, Her2+ 3.37 1.67−6.78 HR+, Her2+ 0.91 0.51−1.60 HR+, Her2− ref. Type of surgery 0.026 Breast conservation therapy 2.05 1.09−3.84 Mastectomy ref. Multidisciplinary team 0.021 Yes 1.98 1.11−3.53 No ref. Type of hospital 0.569 General 1.20 0.73−1.98 Top clinical ref. Academic 1.50 0.64−3.47 Hospital surgical volume 0.729 <100 1.19 0.69−2.06 100–200 ref. >200 1.27 0.70−2.31 Study participation 0.005 Yes 1.80 1.20−2.70 No ref. Conclusions: There is considerable variation in the use of NAC for LABC in the Netherlands. Although various patient, tumor and institutional factors are associated with the use of NAC in LABC, these can only explain part of the observed variation in treatment patterns between hospitals.",
keywords = "METIS-316254, IR-100066",
author = "P.E.R. Spronk and {van Bommel}, A.C.M. and S. Siesling and {Baas-Vrancken Peeters}, M.J.T. and C.H. Smorenburg",
year = "2016",
month = "3",
day = "11",
language = "English",
pages = "S93--S93",
note = "10th European Breast Cancer Conference (EBCC-10) : Multidisciplinary Innovation in Breast Cancer Care, EBCC ; Conference date: 09-03-2016 Through 11-03-2016",

}

Spronk, PER, van Bommel, ACM, Siesling, S, Baas-Vrancken Peeters, MJT & Smorenburg, CH 2016, 'Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands' 10th European Breast Cancer Conference (EBCC-10) , Amsterdam, Netherlands, 9/03/16 - 11/03/16, pp. S93-S93.

Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands. / Spronk, P.E.R.; van Bommel, A.C.M.; Siesling, S.; Baas-Vrancken Peeters, M.J.T.; Smorenburg, C.H.

2016. S93-S93 Abstract from 10th European Breast Cancer Conference (EBCC-10) , Amsterdam, Netherlands.

Research output: Contribution to conferenceAbstractOther research output

TY - CONF

T1 - Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands

AU - Spronk, P.E.R.

AU - van Bommel, A.C.M.

AU - Siesling, S.

AU - Baas-Vrancken Peeters, M.J.T.

AU - Smorenburg, C.H.

PY - 2016/3/11

Y1 - 2016/3/11

N2 - Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands P.E.R. Spronk1, A.C.M. Van Bommel1, S. Siesling2,3, M.J.T. Baas- Vrancken Peeters4, C.H. Smorenburg5. 1Leiden University Medical Centre, Surgery, Leiden, Netherlands; 2Comprehensive Cancer Centre the Netherlands IKNL, Epidemiology, Utrecht, Netherlands; 3University of Twente, MIRA Biomedical science and Technical Medicine, Twente, Netherlands; 4Netherlands Cancer Institute/Antoni van Leeuwenhoek, Surgery, Amsterdam, Netherlands; 5Netherlands Cancer Institute/Antoni van Leeuwenhoek, Medical Oncology, Amsterdam, Netherlands Background: Neoadjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (LABC). The aim of this study is to examine the use of NAC for LABC in all Dutch hospitals participating in breast cancer care and to assess what patient, tumour and hospital characteristics influence its use. Material and Methods: Data were derived from the national multidisciplinary NABON Breast Cancer Audit (NBCA), regarding all women aged >18 years and newly diagnosed with LABC from January 2011 to September 2013. Multivariable logistic regression was used to assess the association between the use of NAC and patient, tumour and hospital related factors. Results: Of 1419 woman diagnosed with LABC, 70% were treated with NAC. This percentage varied from 12.5% to 90% between hospitals and did not increase over time. Factors associated with the use of NAC included young age, large tumour size, more advanced nodal disease and triple negative or hormone-receptor negative tumours. Also patients treated in hospitals with a multidisciplinary preoperative work-up and participation in neoadjuvant studies were more likely to receive NAC. However, considerable variation between hospitals remained after casemix correction. Table 1. Multivariable odds ratios (ORs) for receipt of NAC among 1419 stage III patients 2011 through 2013 OR 95% CI P-value Age 0.000 <40 0.92 0.44−1.94 40−49 ref. 50−59 0.67 0.41−1.09 60−69 0.51 0.31−0.84 70 0.03 0.02−0.05 Histologic subtype 0.145 ductal ref. lobular 0.58 0.34−0.98 both 1.19 0.33−4.29 other 0.55 0.20−1.53 Multifocal 0.997 yes ref. no 1.00 0.67−1.50 Tumor size 0.000 5 cm ref. >5 cm 5.68 2.34−13.79 Clinical nodal status 0.000 cNx/N0 ref. cN1 1.32 0.86−2.04 cN2 2.93 1.18−7.29 cN3 10.28 4.18−25.25 Receptor status 0.000 Triple negative 2.35 1.40−3.93 HR−, Her2+ 3.37 1.67−6.78 HR+, Her2+ 0.91 0.51−1.60 HR+, Her2− ref. Type of surgery 0.026 Breast conservation therapy 2.05 1.09−3.84 Mastectomy ref. Multidisciplinary team 0.021 Yes 1.98 1.11−3.53 No ref. Type of hospital 0.569 General 1.20 0.73−1.98 Top clinical ref. Academic 1.50 0.64−3.47 Hospital surgical volume 0.729 <100 1.19 0.69−2.06 100–200 ref. >200 1.27 0.70−2.31 Study participation 0.005 Yes 1.80 1.20−2.70 No ref. Conclusions: There is considerable variation in the use of NAC for LABC in the Netherlands. Although various patient, tumor and institutional factors are associated with the use of NAC in LABC, these can only explain part of the observed variation in treatment patterns between hospitals.

AB - Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands P.E.R. Spronk1, A.C.M. Van Bommel1, S. Siesling2,3, M.J.T. Baas- Vrancken Peeters4, C.H. Smorenburg5. 1Leiden University Medical Centre, Surgery, Leiden, Netherlands; 2Comprehensive Cancer Centre the Netherlands IKNL, Epidemiology, Utrecht, Netherlands; 3University of Twente, MIRA Biomedical science and Technical Medicine, Twente, Netherlands; 4Netherlands Cancer Institute/Antoni van Leeuwenhoek, Surgery, Amsterdam, Netherlands; 5Netherlands Cancer Institute/Antoni van Leeuwenhoek, Medical Oncology, Amsterdam, Netherlands Background: Neoadjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (LABC). The aim of this study is to examine the use of NAC for LABC in all Dutch hospitals participating in breast cancer care and to assess what patient, tumour and hospital characteristics influence its use. Material and Methods: Data were derived from the national multidisciplinary NABON Breast Cancer Audit (NBCA), regarding all women aged >18 years and newly diagnosed with LABC from January 2011 to September 2013. Multivariable logistic regression was used to assess the association between the use of NAC and patient, tumour and hospital related factors. Results: Of 1419 woman diagnosed with LABC, 70% were treated with NAC. This percentage varied from 12.5% to 90% between hospitals and did not increase over time. Factors associated with the use of NAC included young age, large tumour size, more advanced nodal disease and triple negative or hormone-receptor negative tumours. Also patients treated in hospitals with a multidisciplinary preoperative work-up and participation in neoadjuvant studies were more likely to receive NAC. However, considerable variation between hospitals remained after casemix correction. Table 1. Multivariable odds ratios (ORs) for receipt of NAC among 1419 stage III patients 2011 through 2013 OR 95% CI P-value Age 0.000 <40 0.92 0.44−1.94 40−49 ref. 50−59 0.67 0.41−1.09 60−69 0.51 0.31−0.84 70 0.03 0.02−0.05 Histologic subtype 0.145 ductal ref. lobular 0.58 0.34−0.98 both 1.19 0.33−4.29 other 0.55 0.20−1.53 Multifocal 0.997 yes ref. no 1.00 0.67−1.50 Tumor size 0.000 5 cm ref. >5 cm 5.68 2.34−13.79 Clinical nodal status 0.000 cNx/N0 ref. cN1 1.32 0.86−2.04 cN2 2.93 1.18−7.29 cN3 10.28 4.18−25.25 Receptor status 0.000 Triple negative 2.35 1.40−3.93 HR−, Her2+ 3.37 1.67−6.78 HR+, Her2+ 0.91 0.51−1.60 HR+, Her2− ref. Type of surgery 0.026 Breast conservation therapy 2.05 1.09−3.84 Mastectomy ref. Multidisciplinary team 0.021 Yes 1.98 1.11−3.53 No ref. Type of hospital 0.569 General 1.20 0.73−1.98 Top clinical ref. Academic 1.50 0.64−3.47 Hospital surgical volume 0.729 <100 1.19 0.69−2.06 100–200 ref. >200 1.27 0.70−2.31 Study participation 0.005 Yes 1.80 1.20−2.70 No ref. Conclusions: There is considerable variation in the use of NAC for LABC in the Netherlands. Although various patient, tumor and institutional factors are associated with the use of NAC in LABC, these can only explain part of the observed variation in treatment patterns between hospitals.

KW - METIS-316254

KW - IR-100066

M3 - Abstract

SP - S93-S93

ER -

Spronk PER, van Bommel ACM, Siesling S, Baas-Vrancken Peeters MJT, Smorenburg CH. Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands. 2016. Abstract from 10th European Breast Cancer Conference (EBCC-10) , Amsterdam, Netherlands.