Breast-conserving surgery in locally advanced breast cancer submitted to neoadjuvant chemotherapy. Safety and effectiveness based on ipsilateral breast tumor recurrence and long-term follow-up
Clinics
;
72(3): 134-142, Mar. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-840053
ABSTRACT
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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Breast Neoplasms
/
Carcinoma
/
Mastectomy, Segmental
/
Neoadjuvant Therapy
/
Neoplasm Recurrence, Local
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2017
Type:
Article
/
Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Programa de Pós-Graduação em Oncologia/BR
Similar
MEDLINE
...
LILACS
LIS