Neoadjuvant, or presurgical, therapy has been an increasingly common treatment for breast cancer patients. And while there have been a number of studies looking at treatment outcomes, they have been narrowly focused. What if someone took a more comprehensive look at patient outcomes?
That’s exactly what Nila Jones, MD, a second-year anatomic and clinical pathology resident in UNMC’s Department of Pathology, Microbiology and Immunology, aims to do. She plans to use the READi Core to extract from UNMC’s database cancer synoptic reports and treatment data for breast cancer patients who received neoadjuvant therapy at UNMC between 2014 and 2024. With one to three patients receiving this therapy every week at UNMC, Dr. Jones figures to have up to 1,500 patient cases to review.
“We want to look at patient outcomes through several lenses,” she said, including relationship of outcome to the characteristics of each patient’s cancer—histological findings, hormone status, molecular subtype, and grade.
“We’re looking at different characteristics of each patient’s cancer and making note of how neoadjuvant treatment related to those characteristics and the patient’s outcomes,” she said. “I think what’s special about this type of approach is that it will be more generalized—this is all the cancer we’ve seen, and this is how it all has reacted. In contrast, our literature review led us to many articles focused on one malignant entity or one target. We’re going to parse through the data, see where connections exist, and determine if they’re significant or not.”
The St. Louis native, who earned her MD at the University of Missouri-Kansas City before coming to UNMC for her residency, said her mentor, Dr. Mary Edgerton, suggested the study. “She had been thinking there had been so much change over the past few decades or so that we really should be reanalyzing everything,” Dr. Jones said.
They also hope that by using SNOMED coding coupled to College of American Pathologists (CAP) Cancer Protocols, they can create a data set that is interoperable with other institutions around the world using either CAP Cancer Protocols or International Consortium on Cancer Reporting, which has also been mapped to SNOMED.
Dr. Edgerton added: “We are very excited both to demonstrate the utility of using the CAP Cancer Protocols to bypass time and tedium of excessive medical record curation, but also to be able to use SNOMED to make the data interoperable. We have already had an abstract on this topic accepted to present in person in an onsite oral presentation in the SNOMED CT Expo 2025 program in Antwerp, Belgium, this coming fall. This is a tremendous achievement for Dr. Jones.”