title: Preoperative chemotherapy for T2 breast cancer is associated with improved surgical outcome.
abstract: BACKGROUND
  The aim of this study is to compare the clinical outcome in T2 breast cancer patients who underwent preoperative chemotherapy (PC) and who did not. The study also tried to define a subgroup of patients, who are more beneficial after PC in terms of lower re-excision rates, better cosmetic results and local recurrence free survival.
  
  
  METHODS
  251 consecutive patients treated for nonmetastatic T2 invasive breast cancer were analyzed retrospectively. Of those; 141 underwent primary surgery (PS) followed by chemotherapy, whereas 110 were treated with combination of PC and surgery.
  
  
  RESULTS
  The patients who were treated with PC had a significantly higher incidence of negative margins and lower rate of re-excision (5% vs. 16%, p = 0.02). Of all patients attempted breast conserving surgery (BCS), patients in the PC group were more likely to undergo BCS as their definitive operation compared to patients with PS group (BCS rates; PC group: 99% vs. PS group: 92%, p = 0.05). Multifocal disease (OR: 7, 95% Cl, 2.7-18.4, p = 0.0001) and PC (OR = 0.2; 95% CI, 0.06-0.72, p = 0.01) were factors associated with margin positivity in patients treated with BCS. There was no statistically significant difference in 5 year local-recurrence free survival rates between 2 groups.
  
  
  CONCLUSIONS
  Our study shows that PC significantly decreases the re-excision in patients undergoing BCS with primary T2 breast tumors. This data suggests that any patient with a tumor greater than 2 cm might be considered for PC to increase BCS success with final negative margins.
authors.affiliation: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey. Electronic address: hasankaranlik@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Karanlik
authors.affiliation: Department of Surgery, Acibadem International Hospital, Istanbul, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Ozgur
authors.affiliation: Department of Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Cabioglu
authors.affiliation: Medical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Sen
authors.affiliation: Medical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Erturk
authors.affiliation: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Kilic
authors.affiliation: Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Onder
authors.affiliation: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Deniz
authors.affiliation: Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Yavuz
authors.affiliation: Medical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Aydiner
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000188:drug therapy* / Q000473:pathology; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011300:Preoperative Care; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin; D003520:Cyclophosphamide; D000068878:Trastuzumab
keywords: Breast cancer; Preoperative chemotherapy; T2 breast tumor