title: The Neoadjuvant Net: a patient- and surgeon-friendly device to facilitate safe breast-conserving surgery in patients who underwent neoadjuvant treatment.
abstract: The primary goal of the study was to describe an innovative and helpful tool in defining the minimal surgical margins necessary during breast-conserving surgery (BCS) after neoadjuvant treatment: the Neoadjuvant Net (NN). The secondary endpoint was to assess its usefulness in achieving postoperative disease-free margins and reducing Ipsilateral Breast Tumor Recurrences (IBRTs). The breast-conserving surgical technique together with the use of the Neoadjuvant Net is herein reported. Age, stage at diagnosis, clinical and pathological response, lymph node status, type of surgery, margin status, and incidence of local and distant recurrence were retrospectively analyzed. Seventy-five patients underwent BCS following medical treatment from 2000 to 2011. The majority of the patients had significant size reduction (63/75, 84%). Twenty-two had a complete clinical response but only 11 (11/75, 14.7%) showed a complete pathological response. Two patients (2/75, 2.67%) had infiltrated surgical margins. After a mean follow-up of seventy months, 3 patients (3/75, 4%) had IBRTs and 4 women had distant metastases (4/75, 5.34%). The NN is an easy-to-use, non-invasive instrument designed with the purpose of facilitating the surgeon's task of reducing infiltrated margins and IBTRs.
authors.affiliation: Department of General Surgery, Emergency Surgery and Organ Transplantation, University of Bologna, Policlinico S. Orsola-Malpighi, Via Massarenti, 9, 40138 Bologna, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.forename: Isacco
authors.initials: I
authors.lastname: Montroni
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.forename: Claudio
authors.initials: C
authors.lastname: Zamagni
authors.forename: Monica
authors.initials: M
authors.lastname: Fiacchi
authors.forename: Simone
authors.initials: S
authors.lastname: Zanotti
authors.forename: Alice
authors.initials: A
authors.lastname: Pellegrini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Ugolini
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome