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Clinics ; 72(3): 134-142, Mar. 2017. tab, graf
Article Dans Anglais | LILACS | ID: biblio-840053

Résumé

OBJECTIVE: To evaluate ipsilateral breast tumor recurrence after breast-conserving surgery for locally advanced breast cancer. METHODS: A retrospective observational cohort study was performed in patients with locally advanced breast cancer submitted to breast-conserving surgery after neoadjuvant chemotherapy based on an adriamycin-cyclophosphamide-paclitaxel regimen. We evaluated the clinical, pathologic, immunohistochemistry, and surgical factors that contribute to ipsilateral breast tumor recurrence and locoregional recurrence. A Kaplan-Meier analysis and Cox model were used to evaluate the main factors related to disease-free survival. RESULTS: Of the 449 patients who received neoadjuvant chemotherapy, 98 underwent breast-conserving surgery. The average diameter of the tumors was 5.3 cm, and 87.2% reached a size of up to 3 cm. Moreover, 86.7% were classified as clinical stage III, 74.5% had T3-T4 tumors, 80.5% had N1-N2 axilla, and 89.8% had invasive ductal carcinoma. A pathologic complete response was observed in 27.6% of the tumors, and 100.0% of samples had free margins. The 5-year actuarial overall survival rate was 81.2%, and the mean follow-up was 72.8 months. The rates of ipsilateral breast tumor recurrence and locoregional recurrence were 11.2% and 15.3%, respectively. Multifocal morphology response was the only factor related to ipsilateral breast tumor recurrence disease-free survival (p=0.04). A multivariate analysis showed that the pathologic response evaluation criteria in solid tumors (RECIST)-breast cutoff was the only factor related to locoregional recurrence disease-free survival (p=0.01). CONCLUSIONS: Breast-conserving surgery is a safe and effective therapy for selected locally advanced breast tumors.


Sujets)
Humains , Femelle , Adulte , Adulte d'âge moyen , Tumeurs du sein/chirurgie , Tumeurs du sein/traitement médicamenteux , Carcinomes/chirurgie , Carcinomes/traitement médicamenteux , Mastectomie partielle , Traitement néoadjuvant/méthodes , Récidive tumorale locale/étiologie , Facteurs temps , Tumeurs du sein/anatomopathologie , Carcinomes/anatomopathologie , Analyse de survie , Reproductibilité des résultats , Études rétrospectives , Facteurs de risque , Études de suivi , Résultat thérapeutique , Appréciation des risques , Charge tumorale
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