J Breast Cancer.  2011 Dec;14(4):289-295. 10.4048/jbc.2011.14.4.289.

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

• Lee S
• Kim SW
• Kim SK
• Lee KS
• Kim EA
• Kwon Y
• Shin KH
• Kang HS
• Ro J
• Lee ES

• KMID: 2175722
• DOI: http://doi.org/10.4048/jbc.2011.14.4.289

Abstract

PURPOSE
Preoperative 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).
METHODS
From 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.
RESULTS
The 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.
CONCLUSION
This 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.

Keyword

Breast neoplasms; Breast-conserving surgery; Local recurrence neoplasm; Neoadjuvant therapy

MeSH Terms

Breast
Breast Neoplasms
Disease-Free Survival
Female
Humans
Mastectomy
Mastectomy, Segmental
Multivariate Analysis
Neoadjuvant Therapy
Random Allocation
Recurrence

Figure

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  Figure 1 Study profile. TX=docetaxel+capecitabine; AC=doxorubicin+cyclophosphamide; RECIST=response evaluation criteria in solid tumors.

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