TURKISH JOURNAL OF ONCOLOGY 2008 , Vol 23 , Num 2
Predictive factors for local recurrence after breast conservative surgery following neoadjuvant chemotherapy: our long-term results
Neslihan CABIOĞLU,1 Mahmut MÜSLÜMANOĞLU,1 Abdullah İĞCİ,1 Beyza ÖZÇINAR,1 Vahit ÖZMEN,1 Temel DAĞOĞLU,1 Yeşim ERALP,2 Maktav DİNÇER,3 Işık ASLAY,3 Ekrem YAVUZ,4 Mehtap TUNACI,5 Adnan AYDINER,2 Mustafa KEÇER1
1 İ.Ü. İstanbul Tıp Fakültesi Genel Cerrahi Anabilim Dalı, İstanbul
2 İ.Ü. İstanbul Tıp Fakültesi Tıbbi Onkoloji Bilim Dalı, İstanbul
3 İ.Ü. İstanbul Tıp Fakültesi Radyasyon Onkolojisi Bilim Dalı, İstanbul
4 İ.Ü. İstanbul Tıp Fakültesi Patoloji Anabilim Dalı, İstanbul
5 İ.Ü. İstanbul Tıp Fakültesi Radyoloji ve Onkoloji Enstitüsü ve Klinik Onkoloji Anabilim Dalı, İstanbul
OBJECTIVES
There is still no consensus on the eligibility criteria for breast conservation after neoadjuvant chemotherapy in patients with breast cancer. The present study investigated the long term outcome in patients with breast conservation following chemotherapy to determine its feasibility.

METHODS
Between January 1991 to July 2005, 29 patients with clinical stage 2 or 3 who underwent breast conservative surgery following chemotherapy, were included into the study.

RESULTS
The clinical stages before neoadjuvant chemotherapy were as follows: T0 (n=1), T1 (n=1), T2 (n=14), T3 (n=7), and T4 ( n= 6); and N0 (n=2), N1 (n=9), and N2 (n=17), and N3 (n=1). Out of 4 ipsilateral breast tumor recurrences, 2 local recurrences (7%) were detected in the first 5 years, whereas 4 local recurrences (14%) were detected in the first 10 years. The 5-year and 10- year local recurrence free rates were 91.5% and 75%, and the 5-year and 10-year overall survival rates were 92% and 78%, respectively. The 10-year local recurrence-free survival rate was only found to be higher in patients with T0-2 tumors compared to patients with T3-4 tumors (86%, vs 60%, p=0.078).

CONCLUSION
Breast conservation after neoadjuvant chemotherapy seems to be safe in selected patients with locally advanced disease including those with clinical T0-2 tumors before neoadjuvant chemotherapy. Keywords : Breast conservative surgery; locally advanced breast cancer; neoadjuvant chemotherapy