TY - JOUR
T1 - Oncologic safety of breast-conserving surgery compared to mastectomy in patients receiving neoadjuvant chemotherapy for locally advanced breast cancer
AU - Cho, Jung Hoon
AU - Park, Ji Min
AU - Park, Hyung Seok
AU - Park, Seho
AU - Kim, Seung Il
AU - Park, Byeong Woo
PY - 2013/12
Y1 - 2013/12
N2 - Background Breast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We investigated oncologic outcomes of BCS in patients receiving NCT to treat locally advanced breast cancer (LABC). Methods We reviewed 1,994 patients who underwent surgery with/without NCT. Patients were categorized into three groups according to treatment methods: initial BCS, BCS after NCT (NCT-BCS), and mastectomy after NCT (NCT-MX). Their characteristics and outcomes were analyzed. Results The NCT-BCS group had earlier stage cancer, more hormone receptor-negative and triple-negative breast cancers (TNBC) than the NCT-MX group. However, outcomes did not differ statistically between the two groups. BCS patients receiving NCT were younger, and had more advanced, hormone receptor-negative, HER2-positive, and TNBC breast cancers than BCS patients without NCT. Patients with pathological complete remission (pCR) in the NCT-BCS group had better survival outcomes than non-pCR patients and the initial BCS group. By multivariate analysis in patients receiving NCT, final stage and TNBC were associated with poor overall survival (stage III: P = 0.008; TNBC: P = 0.01), however surgery type was not (P = 0.20). Conclusions BCS after NCT is a safe option for LABC that responded well to NCT. Shrinking tumors with NCT allows more opportunities to apply BCS without compromising outcomes. J. Surg. Oncol. 2013; 108:531-536.
AB - Background Breast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We investigated oncologic outcomes of BCS in patients receiving NCT to treat locally advanced breast cancer (LABC). Methods We reviewed 1,994 patients who underwent surgery with/without NCT. Patients were categorized into three groups according to treatment methods: initial BCS, BCS after NCT (NCT-BCS), and mastectomy after NCT (NCT-MX). Their characteristics and outcomes were analyzed. Results The NCT-BCS group had earlier stage cancer, more hormone receptor-negative and triple-negative breast cancers (TNBC) than the NCT-MX group. However, outcomes did not differ statistically between the two groups. BCS patients receiving NCT were younger, and had more advanced, hormone receptor-negative, HER2-positive, and TNBC breast cancers than BCS patients without NCT. Patients with pathological complete remission (pCR) in the NCT-BCS group had better survival outcomes than non-pCR patients and the initial BCS group. By multivariate analysis in patients receiving NCT, final stage and TNBC were associated with poor overall survival (stage III: P = 0.008; TNBC: P = 0.01), however surgery type was not (P = 0.20). Conclusions BCS after NCT is a safe option for LABC that responded well to NCT. Shrinking tumors with NCT allows more opportunities to apply BCS without compromising outcomes. J. Surg. Oncol. 2013; 108:531-536.
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U2 - 10.1002/jso.23439
DO - 10.1002/jso.23439
M3 - Article
C2 - 24115142
AN - SCOPUS:84887426557
VL - 108
SP - 531
EP - 536
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 8
ER -