title: Cavity margin status is an independent risk factor for local-regional recurrence in breast cancer patients treated with neoadjuvant chemotherapy before breast-conserving surgery.
abstract: The objection of this study is to investigate whether the cavity margin (CM) status has different predictive efficacy for local-regional recurrence (LRR) in patients who have received or have not received neoadjuvant chemotherapy (NAC) before breast-conserving surgery. We identified  61 patients who received NAC before breast-conserving surgery. A nonrandomized unmatched cohort of 295 patients without history of receiving NAC were also included in this study. Clinicopathological features and follow-up data were abstracted and analyzed. Patients in the NAC-treated group  had more advanced diseases when compared with patients in the nonNAC-treated group. With a median follow-up of 42 months, the LRR-free survival rate of patients with positive CMs was significantly lower than that of patients with negative CMs in the NAC-treated group. This distinction was  not observed in the nonNAC-treated group. Univariate and multivariate analysis revealed that positive CM was the only independent predictive factor for LRR in the NAC-treated group but not in nonNAC-treated patients. CM status had different predictive efficacy for LRR in different settings.  Association between CM status and LRR was observed in NAC-treated patients rather than nonNAC-treated patients. More extensive surgical treatment might be needed in NAC-treated patients when their CMs are positive.
authors.affiliation: Department of Breast Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Chen
authors.forename: Weijuan
authors.initials: W
authors.lastname: Jia
authors.forename: Shunrong
authors.initials: S
authors.lastname: Li
authors.forename: Jianrong
authors.initials: J
authors.lastname: He
authors.forename: Yunjie
authors.initials: Y
authors.lastname: Zeng
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.forename: Liang
authors.initials: L
authors.lastname: Jin
authors.forename: Xiayi
authors.initials: X
authors.lastname: Wu
authors.forename: Fengxi
authors.initials: F
authors.lastname: Su
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents