Title: NEOADJUVANT CHEMOTHERAPY UTILISATION AND OUTCOMES IN BREAST CANCER PATIENTS AT A TERTIARY HOSPITAL IN NORTH QUEENSLAND
Authors: Tony Mallett (FRACS, MBBS Hons, BPharm), Michelle Ward (MBBS), Guat Shi Ng (MBBS), Nita Bartlett (FRCS, FRACS, Grad.OPBS).
Townsville University Hospital Breast Unit
Problem Statement:
A 2019 audit of the Breast Surgery Australia New Zealand Quality Audit Database (BQA) has suggested that in Australia neoadjuvant chemotherapy (NAC) is being underutilised.1 It showed a trend for increasing usage (3.08% in 2011 to 6.65% in 2016), this compares poorly with the United States of America (from 2003 to 2011 overall 17.4% utilisation), and falls short of the estimated 20% of patients with breast cancer who would gain benefit from neoadjuvant chemotherapy.  Unfortunately the BQA database did not include accurate pretreatment clinical and radiological sizing and there was significant missing data regarding final pathology so the rate of pathological complete response (pCR) was unable to be assessed.
We sought to determine the rate of neoadjuvant chemotherapy use in our service, the factors influencing use, the response rates, disease progression and recurrence.
Methods:
All patients in the Townsville and Hinterland Health Service who presented with early and locally advanced breast cancer from January 2015 to December 2020 were included. Response to chemotherapy was classified using the same criteria as the EORTC trial 10902.
Results:
473 patients were included over the 6 year period. The rate of NAC usage rose from 11.2% in 2015 to 16.2% in 2020. Young age, HER2 positive or triple negative receptor status, large tumours and locally advanced disease were associated with NAC use. The complete pathological response rate was 27.5%, the partial response rate 31% and disease progression 5.8% overall. Recurrence in the neoadjuvant group was 24.6% and mortality 17.4%. The mean pre-treatment tumour size was over 40mm.
Conclusions:
Neoadjuvant chemotherapy utilisation in our service is in line with international standards. The rural and remote nature of the Townsville catchment, and the number of patients presenting with locally advanced malignancies and access to Medical oncology via Telehealth may be contributing to both neoadjuvant utilisation and the recurrence rates and associated mortality.
Disclosures:
Nil
References:
1. Patiniott P, Wong G, Lam Y, et al. Neoadjuvant chemotherapy rates for breast cancer in Australia – :are we there yet?” Ann Breast Surg 2019; 3:9.

**Title:** NEOADJUVANT CHEMOTHERAPY UTILISATION AND OUTCOMES IN BREAST CANCER PATIENTS AT A TERTIARY HOSPITAL IN NORTH QUEENSLAND
**Authors:** Tony Mallett (FRACS, MBBS Hons, BPharm), Michelle Ward (MBBS), Guat Shi Ng (MBBS), Nita Bartlett (FRCS, FRACS, Grad.OPBS).
Townsville University Hospital Breast Unit
**Problem Statement:**
A 2019 audit of the Breast Surgery Australia New Zealand Quality Audit Database (BQA) has suggested that in Australia neoadjuvant chemotherapy (NAC) is being underutilised.1 It showed a trend for increasing usage (3.08% in 2011 to 6.65% in 2016), this compares poorly with the United States of America (from 2003 to 2011 overall 17.4% utilisation), and falls short of the estimated 20% of patients with breast cancer who would gain benefit from neoadjuvant chemotherapy.  Unfortunately the BQA database did not include accurate pretreatment clinical and radiological sizing and there was significant missing data regarding final pathology so the rate of pathological complete response (pCR) was unable to be assessed.
We sought to determine the rate of neoadjuvant chemotherapy use in our service, the factors influencing use, the response rates, disease progression and recurrence.
**Methods:**
All patients in the Townsville and Hinterland Health Service who presented with early and locally advanced breast cancer from January 2015 to December 2020 were included. Response to chemotherapy was classified using the same criteria as the EORTC trial 10902.
**Results:**
473 patients were included over the 6 year period. The rate of NAC usage rose from 11.2% in 2015 to 16.2% in 2020. Young age, HER2 positive or triple negative receptor status, large tumours and locally advanced disease were associated with NAC use. The complete pathological response rate was 27.5%, the partial response rate 31% and disease progression 5.8% overall. Recurrence in the neoadjuvant group was 24.6% and mortality 17.4%. The mean pre-treatment tumour size was over 40mm.
**Conclusions:**
Neoadjuvant chemotherapy utilisation in our service is in line with international standards. The rural and remote nature of the Townsville catchment, and the number of patients presenting with locally advanced malignancies and access to Medical oncology via Telehealth may be contributing to both neoadjuvant utilisation and the recurrence rates and associated mortality.
**Disclosures:**
Nil
**References:**
1. Patiniott P, Wong G, Lam Y, et al. Neoadjuvant chemotherapy rates for breast cancer in Australia – :are we there yet?” Ann Breast Surg 2019; 3:9.

NEOADJUVANT CHEMOTHERAPY UTILISATION AND OUTCOMES IN BREAST CANCER PATIENTS AT A TERTIARY HOSPITAL IN NORTH QUEENSLAND

We are pleased to welcome you to the Australasian International Breast Congress (AIBC) held jointly with the [Australasian Society for Breast Disease (ASBD)](https://www.asbd.org.au/),[6th World Congress on Controversies in Breast Cancer (CoBrCa)](http://cobrca.org/) and [Breast Surgeons of Australia and New Zealand (BreastSurgANZ) in Brisbane, Australia](https://www.breastsurganz.org/).

The Joint Congress will continue the tradition of directly addressing key issues facing clinicians in their daily practice, including medical oncology, surgery, radiation oncology, breast imaging, pathology, reconstruction, allied health and survivorship issues.

We are delighted to have assembled a stellar international and national faculty and thank all those who have agreed to participate and those who have submitted abstracts. We trust that the program is an informative and enjoyable experience.

Thank you for joining us.