title: Breast conserving surgery after neoadjuvant therapy for large primary breast cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety of breast conserving surgery in patients with breast tumours satisfactorily downstaged after neoadjuvant therapy.
  
  
  METHODS
  A retrospective cohort study was undertaken to analyze the loco-regional recurrence (LRR) after breast conserving surgery. We enrolled 88 patients with breast cancer subjected to neoadjuvant therapy (NAT group) who achieved an objective response due to neoadjuvant treatment and compared them with 191 patients with early breast cancer (EBC group) who were submitted to primary conserving surgery. Lumpectomy or quadrantectomy with axillary lymph node dissection was performed in all patients who received adjuvant radiotherapy. Systemic adjuvant therapy was offered to all patients. The mean periods of observation were 61.3 months in the NAT group and 67.5 months in the EBC group.
  
  
  RESULTS
  The mean age was 53 years in the NAT group and 56 years in the EBC group (p=0.04). There was no histological type and histological grade difference between groups. In the NAT group, the mean diameter of residual tumour was lower and the mean volume of breast tissue resection was higher than in the EBC group (p=0.01 and p=0.002, respectively). The ipsilateral recurrence rate was 7.9% in the NAT group and 7.8% in the EBC group (p=0.9). The most important predictive factor of recurrence in the NAT group was the age of patient.
  
  
  CONCLUSIONS
  Breast conserving therapy is a safe procedure in satisfactorily downstaged breast cancer after neoadjuvant therapy.
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Monte Alegre, 8° floor Ribeirão Preto, São Paulo 14048-900, Brazil. Electronic address: dtiezzi@hcrp.fmrp.usp.br.
authors.forename: D G
authors.initials: DG
authors.lastname: Tiezzi
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Monte Alegre, 8° floor Ribeirão Preto, São Paulo 14048-900, Brazil.
authors.forename: J M
authors.initials: JM
authors.lastname: Andrade
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Monte Alegre, 8° floor Ribeirão Preto, São Paulo 14048-900, Brazil.
authors.forename: H R C
authors.initials: HRC
authors.lastname: Marana
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Monte Alegre, 8° floor Ribeirão Preto, São Paulo 14048-900, Brazil.
authors.forename: F E
authors.initials: FE
authors.lastname: Zola
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Monte Alegre, 8° floor Ribeirão Preto, São Paulo 14048-900, Brazil.
authors.forename: F M
authors.initials: FM
authors.lastname: Peria
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome