Predictive risk factors of recurrence in breast cancer after neoadjuvant treatment: the NEORISK study

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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.