Clinical practice and outcome of breast-conserving treatment: the effectiveness of preoperative systemic chemotherapy.
In patients with breast cancer, surgical intervention combined with preoperative chemotherapy improves breast conservation rates, and the long-term clinical results of patients undergoing preoperative chemotherapy is comparable to those receiving postoperative chemotherapy. The sequential administration of anthracycline (A) and taxanes (T) is now thought to be the most effective treatment regimen. We treated 296 patients with A and T sequentially and examined the clinical and pathological results. A total of 14% of the patients achieved a clinical complete response (cCR) and 9.5% achieved a pathological complete response (pCR). Tumor classification determined by imaging did not predict pCR, but CT findings helped determine appropriate resection margins. One hundred thirteen patients (38%) received lumpectomy following chemotherapy, and 24.7% (28/113) had positive tumor margins and the malignant cells tended to remain in invasive components. Prognosis was not associated with clinical stage and clinical response, but histopathological findings were closely related to prognosis. Future studies should attempt to develop an optimal chemotherapy regimen, set an appropriate resection margin, and find an effective treatment for patients with extensively calcified lesions.
Fukutomi
Takashi
T
Department of Surgical Oncology, National Cancer Center Hospital, Aichi Medical University, Japan. tfukutom@mcc.go.jp
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007564:Japan; D015412:Mastectomy, Segmental / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome