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Oncologic Safety of Breast-Conserving Surgery Compared to Mastectomy in Patients Receiving Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer

 Jung Hoon Cho  ;  Ji Min Park  ;  Hyung Seok Park  ;  Seho Park  ;  Seung Il Kim  ;  Byeong-Woo Park 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.108(8) : 531-536, 2013 
Journal Title
Issue Date
Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Breast Neoplasms/drug therapy* ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology ; Breast Neoplasms/prevention & control ; Breast Neoplasms/surgery* ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/surgery ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Mastectomy, Modified Radical* ; Mastectomy, Segmental* ; Medical Records ; Middle Aged ; Neoadjuvant Therapy/methods* ; Neoplasm Grading ; Neoplasm Recurrence, Local/prevention & control* ; Neoplasm Staging ; Republic of Korea ; Retrospective Studies ; Treatment Outcome ; Triple Negative Breast Neoplasms/drug therapy ; Triple Negative Breast Neoplasms/surgery
breast ; neoplasms ; mastectomy ; segmental ; neoadjuvant therapy ; locally advanced breast cancer ; survival analysis
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Il(김승일)
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Ji Min(박지민)
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
Cho, Jung Hoon(조정훈)
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