Locoregional Recurrence of Breast Conserving Surgery after Preoperative Chemotherapy in Korean Women with Locally Advanced Breast Cancer

Abstract

PurposePreoperative chemotherapy has been used to increase the rate of breast conserving surgery (BCS) in Caucasian women. However, whether it would also increase the rate of BCS in Korean women has not been verified. The aim of this study was to determine the effectiveness of preoperative chemotherapy to make BCS possible in Korean women who have locally advanced cancer without any increase of locoregional recurrence according to operation methods (BCS vs. mastectomy).MethodsFrom August 2002 to April 2005, 205 patients with stage II or III breast cancer were enrolled in a phase III randomized trial of preoperative chemotherapy. Surgeons decided on the type of surgery (mastectomy or BCS) at initial diagnosis. By randomization, patients received four cycles of either docetaxel/capecitabine or doxorubicin/cyclophosphamide followed by surgery and crossover to the other treatment as postoperative chemotherapy.ResultsThe mean tumor size was 3.29 cm and the mean breast volume was 489 cc at diagnosis. After preoperative chemotherapy, clinical response was shown in 76.0% of the patients. Of the 71 patients planned for a mastectomy at initial diagnosis, 27 patients underwent BCS (38.0%). Clinical T stage after preoperative chemotherapy, pathologic T size and lymphatic invasion were correlated with conversion to BCS. In multivariate analysis, only lymphatic invasion showed statistical significance. Locoregional disease-free survival did not statistically differ between the two operation methods for the patients who were planned for a mastectomy at the initial exam.ConclusionThis study showed that preoperative chemotherapy also increased the rate of BCS, while avoiding any increase of locoregional recurrence in Korean women with locally advanced breast cancer.

Mastectomy for management of breast cancer in Ibadan, Nigeria

“…Only a negligible number of our patients had breast conserving surgery (BCS). Early presentation and the availability and extensive use of adjuvant therapies have made BCS to gain widespread usage in some parts of the world [ 27 , 28 ]. This is especially so in developed countries where evidence now abounds that it is as effective as MRM in early breast cancer [ 2 , 29 ].…”

Impact of Molecular Subtype Conversion of Breast Cancers after Neoadjuvant Chemotherapy on Clinical Outcome

“…As many of the patients were also participants in various clinical trials of NAC that were being conducted at the National Cancer Centre, Korea, during this period, the NAC regimens were not uniform for all patients [ 15 , 16 ]. The regimens included four cycles of doxorubicin and cyclophosphamide, four cycles of doxorubicin and cyclophosphamide followed by four cycles of either docetaxel or paclitaxel, six cycles of doxorubicin and docetaxel, four cycles of paclitaxel and gemcitabine, and six cycles of paclitaxel, gemcitabine, and trastuzumab or lapatinib.…”

Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis

“…BCS rates reportedly increased overall after NAC [ 31 ]. In our study, we analyzed patients with and without cCR who received BCS and found that BCS was more likely to be successful in cCR patients.…”