Breast-conserving surgery in locally advanced breast cancer submitted to neoadjuvant chemotherapy. Safety and effectiveness based on ipsilateral breast tumor recurrence and long-term follow-up

Autor(es)

Guilherme Freire Angotti Carrara ^[1] ; Cristovam Scapulatempo-Neto ^[2] ; Lucas Faria Abrahão-Machado ^[3] ; Maria Mitzi Brentani ^[4] ; João Soares Nunes ^[5] ; Maria Aparecida Azevedo Koike Folgueira ^[6] ; René Aloisio da Costa Vieira

Afiliação do(s) autor(es)

^[1] Programa de Pós-Graduação em Oncologia. Hospital de Câncer de Barretos - Brasil

^[2] Hospital de Câncer de Barretos. Departamento de Patologia - Brasil

^[3] Hospital de Câncer de Barretos. Departamento de Patologia - Brasil

^[4] Universidade de São Paulo. Disciplina de Oncologia. Departamento de Radiologia - Brasil

^[5] Hospital de Câncer de Barretos. Departamento de Oncologica Clínica - Brasil

^[6] Universidade de São Paulo. Disciplina de Oncologia. Departamento de Radiologia - Brasil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 72, n. 3, p. 134-142, 2017-03-00.

Resumo

OBJECTIVE: To evaluate ipsilateral breast tumor recurrence after breast-conserving surgery for locally advanced breast cancer. METHODS: A retrospective observational cohort study was performed in patients with locally advanced breast cancer submitted to breast-conserving surgery after neoadjuvant chemotherapy based on an adriamycin-cyclophosphamide-paclitaxel regimen. We evaluated the clinical, pathologic, immunohistochemistry, and surgical factors that contribute to ipsilateral breast tumor recurrence and locoregional recurrence. A Kaplan-Meier analysis and Cox model were used to evaluate the main factors related to disease-free survival. RESULTS: Of the 449 patients who received neoadjuvant chemotherapy, 98 underwent breast-conserving surgery. The average diameter of the tumors was 5.3 cm, and 87.2% reached a size of up to 3 cm. Moreover, 86.7% were classified as clinical stage III, 74.5% had T3-T4 tumors, 80.5% had N1-N2 axilla, and 89.8% had invasive ductal carcinoma. A pathologic complete response was observed in 27.6% of the tumors, and 100.0% of samples had free margins. The 5-year actuarial overall survival rate was 81.2%, and the mean follow-up was 72.8 months. The rates of ipsilateral breast tumor recurrence and locoregional recurrence were 11.2% and 15.3%, respectively. Multifocal morphology response was the only factor related to ipsilateral breast tumor recurrence disease-free survival (p=0.04). A multivariate analysis showed that the pathologic response evaluation criteria in solid tumors (RECIST)-breast cutoff was the only factor related to locoregional recurrence disease-free survival (p=0.01). CONCLUSIONS: Breast-conserving surgery is a safe and effective therapy for selected locally advanced breast tumors. (AU)

• Processo FAPESP: 12/19642-0 - Análise de fatores clínico-patológicos relacionados a resposta patológica completa e recorrência local em pacientes portadoras do carcinoma mamário localmente avançado, submetidas a quimioterapia neoadjuvante
• Beneficiário: René Aloisio da Costa Vieira
• Modalidade de apoio: Auxílio à Pesquisa - Regular