Breast conservative surgery after neoadjuvant oncologic treatment for breast carcinoma at the 1^st Department of Surgery, 1^st Faculty of Medicine of Charles University and General Teaching Hospital in Prague over a ten-year period (2004−2013)

Czech version

Authors: J. Šuk; I. Schwarzbacherová; K. Kimleová
Authors‘ workplace: I. chirurgická klinika 1. LF Univezrity Karlovy a VFN v Praze přednosta: prof. MUDr. Z. Krška, CSc.
Published in: Rozhl. Chir., 2017, roč. 96, č. 10, s. 432-437.
Category: Original articles

Overview

Introduction:
Since the first breast conservative surgery following neoadjuvant oncotherapy performed in the 1990s, there has been a shift in indications, diagnostic, surgical and oncotherapeutic procedures. The aim of the study is to present the results of the comprehensive treatment of patients with breast conservative surgery performed after neoadjuvant oncologic treatment for breast cancer at our department of surgery.

Method:
A retrospective study involving 96 patients operated on at our department between 2004 and 2013. The median follow-up time is 6 years and 8 months after the diagnosis.

Results:
Breast recurrence was found in 2 (2.1%) cases. No axillary recurrence occurred. A total of 8 (8.3%) patients with generalized carcinoma of the breast died. Total remission was achieved in 81 (84.4%) patients. 76 (79.2%) patients survive in the CR.

Conclusions:
The results of the studies mentioned below as well as our results have shown that BCS after neoadjuvant oncologic therapy is safe and effective in appropriately selected patients.

Key words:
breast cancer − neoadjuvant therapy – breast-conserving surgery – recurrence –cosmetic outcome

Sources

1. Jandík P. Operace karcinomu prsu po neadjuvantní léčbě – výhody a nevýhody z pohledu chirurga a přínos pro pacientku. Breast Cancer News 2015;5:10−4.

2. Coufal O, Fait V, Foltinová V, et al. Chirurgická léčba karcinomu prsu v MOÚ. Rozhl Chir 2007;86:540−7.

3. Duda M, Hartl P, Hartlová M, et al. Záchovné operace karcinomu prsu, Rozhl Chir 1997;76:605−8.

4. Fait V, Chrenko V, Gatěk J. Sentinelová biopsie u karcinomu prsu a neoadjuvantní chemoterapie. Klin Onkol 2005;18:77−9.

5. Fait V, Chrenko V, Schneiderová M, et al. Změny ve spektru operací prsu po zavedení mahárního screeningu. Klin Onkol 2007;20:38−41.

6. Fait V, Coufal O, Gatěk J. Chirurgie karcinomu prsu v České republice. Rozhl Chir 2010;89:229−30.

7. Fait V, Coufal O, Gatěk J. Chirurgie karcinomu prsu v České republice. Klin Onkol 2009;22:294–5.

8. Gatěk J, Duben J, Dudešek B, et al. Výsledky konzervativní terapie u časného karcinomu prsu. Rozhl Chir 2000;79:201−5.

9. Chrenko V, Žaloudík J, Pačovský Z, et al. Parciální mastektomie v terapii mléčné žlázy. Rozhl Chir 1992;71:15−20.

10. Chrenko V, Fait V, Vagunda V, et al. Konzervativní chirurgie v rámci komplexní léčby karcinomu prsu. Klin Onkol 1997;10:54−9.

11. Chrenko V, Fait V, Rejthar A, et al. Konzervativní léčba časných stadií karcinomu prsu. Klin Onkol 1995;8:120−3.

12. Jandík P. Neoadjuvance u karcinomu prsu. Breast Cancer News 2016;6:25−30.

13. Jandík P. Pohled chirurga na operační výkon po neoadjuvanci. Breast Cancer News 2011;1:5−9.

14. Petráková K, Růžičková J, Fait V. Léčebné postupy u karcinomuprsu. Klin Onkol 2008;21:131−40.

15. Zhou X, Li Y. Local recurrence after breast-conserving surgery and mastectomy following neoadjuvant chemotherapy for locally advanced breast cancer − a meta-analysis. Breast Care 2016;11:345−51.

16. T A, Mittendorf EA, Kelly KK. Surgical considerations after neoadjuvant chemotherapy: Breast conservation therapy. J Natl Cancer Inst Monogr 2015;51:11−4.

17. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience. J Clin Oncol 2004;22:2303–12.

18. Mamounas EP, Anderson SJ, Dignam JJ, et al. Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of National Surgical Adjuvant Breast and Bowel Project B-18 and B-27. J Clin Oncol 2012;30:3960–6.

19. Mittendorf EA, Buchholz TA, Tucker SL, et al. Impact of chemotherapy sequencing on local-regional failure risk in breast cancer patients undergoing breast-conserving therapy. Ann Surg 2013;257:173–9.

20. Tiezzi DG, Moreira de Andrade J, Marana HRC, et al. Breast conserving surgery after neoadjuvant therapy for large primary breast cancer. EJSO 2008;34:863−7.