Background: Neoadjuvant chemotherapy (NACT) improves oncologic and cosmetic outcomes in breast cancer (BC), yet recurrence remains a concern. This study identifies factors associated with recurrence at 3 and 5 years in BC patients receiving NACT. Methods: A retrospective analysis of 933 stage I–III BC patients (2014–2021) evaluated event-free survival (EFS) predictors using multivariate analyses. Results: Lower 5-year EFS was linked to axillary staging (cN, p < 0.001), molecular subtype (p < 0.001), surgery type (p = 0.030), and post-surgical nodal status (ypN, p = 0.005). High recurrence risk was observed with aggressive tumor biology, advanced disease, and residual nodal burden, while favorable responses correlated with better outcomes. Conclusion: Biological and clinical factors guide post-NACT strategies to reduce recurrence in high-risk BC patients.
De Franco, A., Carbognin, L., Paris, I., Di Leone, A., Orlandi, A., Marazzi, F., Mule', A., Belli, P., Rossi, A., Magno, S., Palazzo, A., Masiello, V., Santoro, A., Fuso, P., Bria, E., D'Archi, S., Scardina, L., Sanchez, A. M., Giannarelli, D., Paternello, S., Garganese, G., Scambia, G., Tortora, G., Masetti, R., Franceschini, G., Fabi, A., Predictive risk factors of recurrence in breast cancer after neoadjuvant treatment: the NEORISK study, <<FUTURE ONCOLOGY>>, 2025; 21 (17): 2215-2223. [doi:10.1080/14796694.2025.2516410] [https://hdl.handle.net/10807/337350]
Predictive risk factors of recurrence in breast cancer after neoadjuvant treatment: the NEORISK study
De Franco, Antonio;Paris, Ida;Di Leone, Alba;Orlandi, Armando;Marazzi, Fabio;Mule', Antonino;Belli, Paolo;Magno, Stefano;Palazzo, Antonella;Masiello, Valeria;Santoro, Angela;Fuso, Paola;Bria, Emilio;D'Archi, Sabatino;Scardina, Lorenzo;Sanchez, Alejandro Martin;Giannarelli, Diana;Paternello, Stefano;Garganese, Giorgia;Scambia, Giovanni;Tortora, Giampaolo;Masetti, Riccardo;Franceschini, Gianluca;Fabi, Alessandra
2025
Abstract
Background: Neoadjuvant chemotherapy (NACT) improves oncologic and cosmetic outcomes in breast cancer (BC), yet recurrence remains a concern. This study identifies factors associated with recurrence at 3 and 5 years in BC patients receiving NACT. Methods: A retrospective analysis of 933 stage I–III BC patients (2014–2021) evaluated event-free survival (EFS) predictors using multivariate analyses. Results: Lower 5-year EFS was linked to axillary staging (cN, p < 0.001), molecular subtype (p < 0.001), surgery type (p = 0.030), and post-surgical nodal status (ypN, p = 0.005). High recurrence risk was observed with aggressive tumor biology, advanced disease, and residual nodal burden, while favorable responses correlated with better outcomes. Conclusion: Biological and clinical factors guide post-NACT strategies to reduce recurrence in high-risk BC patients.
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