Title |
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
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Published in |
Clinics, March 2017
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DOI | 10.6061/clinics/2017(03)02 |
Pubmed ID | |
Authors |
Guilherme Freire Angotti Carrara, Cristovam Scapulatempo-Neto, Lucas Faria Abrahão-Machado, Maria Mitzi Brentani, João Soares Nunes, Maria Aparecida Azevedo Koike Folgueira, René Aloisio da Costa Vieira |
Abstract |
To evaluate ipsilateral breast tumor recurrence after breast-conserving surgery for locally advanced breast cancer. 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. 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). Breast-conserving surgery is a safe and effective therapy for selected locally advanced breast tumors. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 65 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 9 | 14% |
Researcher | 5 | 8% |
Student > Ph. D. Student | 5 | 8% |
Student > Bachelor | 5 | 8% |
Other | 4 | 6% |
Other | 13 | 20% |
Unknown | 24 | 37% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 25 | 38% |
Nursing and Health Professions | 3 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Biochemistry, Genetics and Molecular Biology | 2 | 3% |
Unspecified | 2 | 3% |
Other | 4 | 6% |
Unknown | 27 | 42% |