Breast-conserving treatment after neoadjuvant chemotherapy in large breast cancer.
Several recent trials have demonstrated that neoadjuvant chemotherapy can allow more patients to successfully undergo breast-conserving treatment (BCT), and does not confer a survival disadvantage compared with standard adjuvant chemotherapy. In addition, the pathological response of primary breast tumors to neoadjuvant chemotherapy appears to be a surrogate marker for patient outcome. In our series, during the period from May 1995 to December 2000, 86 patients with tumors between 3.1 and 6.0 cm in diameter received epirubicin-based neoadjuvant chemotherapy. There were 55 (64.0%) responders and ultimately 64 patients (74.4%) were treated with BCT. The margin positive rate was 14.1%(9/64), similar to the rate after BCT for early-stage breast cancers, the largest diameter of which was smaller than 3 cm. At a median follow-up of 30 months, only 3 patients in the BCT group have developed local recurrence; the local recurrence rate appears to be comparable to that after BCT for early stage breast cancers. Long term follow-up is required, however, to establish whether this procedure is a safe alternative to mastectomy for patients with large breast cancers.
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Japan.
Hideo
H
Inaji
Yoshifumi
Y
Komoike
Kazuyoshi
K
Motomura
Tsutomu
T
Kasugai
Yuka
Y
Sawai
Masahiko
M
Koizumi
Takayuki
T
Nose
Hiroki
H
Koyama
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local
D000970:Antineoplastic Agents; D015251:Epirubicin