Neoadjuvant chemotherapy in patients with stages II and III breast cancer.
BACKGROUND
Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy.


METHODS
This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer. The patients in Group 1 (n = 54) were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 (n = 43) initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed.


RESULTS
Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II (P = 0.034) and 0% to 12.6% in stage III (P = 0.016), and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II (P = 0.046) and 28.1% to 8.1% in stage III (P = 0.026). After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 (68.4% vs 31.2%, P = 0.028, and 63.2% vs 25.0%, P = 0.024, respectively). There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 (85.7% vs 85.2%, P = 0.953, and 80.6% vs 74.1%, P = 0.400, respectively).


CONCLUSIONS
Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in stage III disease. However, neoadjuvant chemotherapy did not confer greater survival on stage II disease.
Yuan
Zhu
Z
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Qu
Xiang
X
Zhang
Zhong-Tao
ZT
Wang
Yu
Y
D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome