P041. Systematic review of surgical and patient reported outcomes of neoadjuvant endocrine therapy for breast cancer

Brett, Beatrice, Savva, Constantinos, Davies, Lucy, Douek, Michael, Copson, Ellen and Cutress, Ramsey (2021) P041. Systematic review of surgical and patient reported outcomes of neoadjuvant endocrine therapy for breast cancer. European Journal of Surgical Oncology, 47 (5), e306-e307. (doi:10.1016/j.ejso.2021.03.045).

Abstract

Introduction: neoadjuvant endocrine therapy (NET) represents a treatment option for downstaging in postmenopausal women with ER-positive early breast cancer. It is available where chemotherapy is not indicated or not judged to be of benefit, and NET produces equivalent clinical and radiological responses to neoadjuvant chemotherapy but with lower toxicity. However, comparison of NET to standard of care surgery first followed by adjuvant therapy is less clear, particularly in relation to surgical outcomes including breast-conservation, re-excision and positive margin rates, quality of life (QoL) and recurrence.

Methods: a systematic review following PRISMA guidelines to evaluate the effect of NET on surgical outcomes QoL and recurrence (Prospero registration ID: CRD42020209257). We searched PubMed and EMBASE to identify clinical trial and cohort studies between 1946 to 05/10/2020. Identified records were manually screened by title, abstract and full-text review by two independent reviewers. Data extraction will be conducted using a pre-piloted data collection tool. Risk of bias will be assessed using Cochrane Collaboration tools.

Results: the search identified 2368 articles. After removing duplicates, 1610 articles were eligible for title screening. Title screening resulted in 323 articles eligible for abstract screening and 35 eligible for full-text review. Eight papers were identified by reference checking, and in total 23 papers were eligible for final review. Data extraction and evidence synthesis is currently in progress.

Conclusion: understanding surgical and patient-reported outcomes with NET may impact surgical practice. The evaluation of current evidence will also inform future trials assessing the impact of NET on surgical outcomes and QoL.

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Contributors

Author: Constantinos Savva

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