The effect of delayed adjuvant chemotherapy on relapse of triplenegative breast cancer

Shuang Li, Ding Ma, Hao-Hong Shi, Ke-Da Yu, Qiang Zhang


Background: For triple negative breast cancer (TNBC), the optimal time from surgery to initiation of adjuvant chemotherapy is controversial. We investigated the influence of time to adjuvant chemotherapy on outcome in TNBC patients.
Methods: Female patients with stage I–IIIa operable TNBC between 2006 and 2008 in our institutions were included. A total of 331 patients were divided into 3 groups according to the time to adjuvant chemotherapy: ≤30, 31–60, and >60 days. Relapse free survival (RFS) were calculated and compared.
Results: Prolonged delay of initiation of adjuvant chemotherapy (≤30 versus >60 days) significantly decreased the RFS in our TNBC cohort [adjusted hazard ratio (HR) of 2.39; 95% confidence interval (CI), 1.13–5.07, P=0.02]. While a moderate delay (≤30 versus 31–60 days) did not significantly influence RFS in all TNBC patients, it did compromise survival in lymph node positive patients (P=0.04).
Conclusions: Longer delay of adjuvant chemotherapy was associated with worse survival in TNBC patients. Early initiation of adjuvant chemotherapy should be considered, especially for relatively high risk node positive TNBCs.