title: Optimizing the indication for breast-conservative surgery (BCS) in patients with locally-advanced breast cancer.
abstract: BACKGROUND
  The main benefit of neoadjuvant chemotherapy is a reduction in tumor size, which allows breast-conserving surgery (BCS) in patients who otherwise would have required a mastectomy. Breast magnetic resonance (MRI) has been proposed to evaluate tumor extent after neoadjuvant chemotherapy, to determine which patients have become eligible for BCS.
  
  
  OBJECTIVE
  The aim of our study was to determine how the association of breast MRI to routine clinical and radiologic assessment of the tumor at initial presentation, and after chemotherapy, affects the overall surgical decision process.
  
  
  METHODS
  54 women with stage IIB-IIIB breast cancer were prospectively enrolled in a study investigating the effects of MRI on the surgical decision.
  
  
  RESULTS
  Surgical plan was changed from BCS to radical mastectomy in 6 cases (13.04%). As a result of using MRI in evaluating disease extent, 21.73% of valuable data were added by MRI (pectoralis major muscle and skin invasion, multifocal multicentric disease). Due to MRI examination 28 (60.86%) of the patients with operable breast cancer after neoadjuvant chemotherapy, were eligible for BCS.
  
  
  CONCLUSIONS
  Our study demonstrates that MRI is the most accurate in determination of tumor size and extent, and in establishing eligibility for BCS.
authors: Ovidius University of Constanta, Romania. lauragrigorov@gmail.com
authors: L
authors: L
authors: Mazilu
authors: A I
authors: AI
authors: Suceveanu
authors: D
authors: D
authors: Tomescu
authors: N
authors: N
authors: Ciufu
authors: R
authors: R
authors: Baz
authors: A P
authors: AP
authors: Suceveanu
authors: I R
authors: IR
authors: Parepa
authors: D E
authors: DE
authors: Tofolean
authors: F
authors: F
authors: Voinea
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D018579:Patient Selection; D057234:Preoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary