title: [The application of conservative surgery for local advanced and bigger primary breast carcinoma].
abstract: OBJECTIVE
  To discuss the application of conservative surgery for local advanced and bigger primary breast carcinoma (> 4 cm in diameter).
  
  
  METHODS
  Thirty-three primary breast cancer patients with tumor diameter more than four centimeters were treated with wide local excision and axillary lymph node dissection. Before operation, neoadjuvant chemotherapy with anthracyclines based combined regimen was done in thirty-one patients.
  
  
  RESULTS
  Thirty-one patients received one to eight cycles of neoadjuvant chemotherapy (mean 3.7 cycles). The response rate was 100%, including clinical complete remission in 19 cases, clinical partial remission in 12 cases and pathological complete remission in 9 cases. The final margin negative rate was 100% in thirty-three patients and first margin negative rate was 75.8% during operation. After a median follow-up of 27 months (range 2-39 months), up to date yet, no relapse case was found. The relapse-free survival was 100%.
  
  
  CONCLUSIONS
  Combining with neoadjuvant chemotherapy, breast-conserving therapy can be done successfully for most primary breast cancer patients with local advanced and bigger tumor. The curative effect was the same as the patient with smaller tumor in a short term follow-up.
authors.affiliation: Breast Cancer Center, Beijing Cancer Hospital, School of Oncology, Peking University, Beijing 100036, China. jinfeng_li@hotmail.com
authors.forename: Jin-feng
authors.initials: JF
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Ouyang
authors.forename: Tian-feng
authors.initials: TF
authors.lastname: Wang
authors.forename: Yun-tao
authors.initials: YT
authors.lastname: Xie
authors.forename: Ben-yao
authors.initials: BY
authors.lastname: Lin
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil