Feasibility of Breast Conserving Surgery in Stage IIIA Breast Carcinoma Patients in the Absence of Neoadjuvant Therapy

Background: preoperative determination of the extent of viable residual tumor isan important issue after neoadjuvant treatment. on the other hand, retrospective datasuggest that breast-conserving surgery is feasible up to stage iiia breast cancer withoutpreoperative therapy.methods: we retrospectively analyzed 164 patients who underwent breastconservingsurgery followed by adjuvant chemotherapy and/or endocrinal therapy withwhole breast radiation between 2005 and 2012. of those, 116 patients had stages i andii (group 1) breast cancer, whereas 48 patients had stage iiia (group 2).results:after a median follow-up of 40.4 months, 18 (15.5%) patients in group-1and 8 (16.6%) in group-2 developed ipsilateral breast tumor recurrence (p=0.77). meantime to tumor recurrence was 19 months in group 1 and 17 months in group 2 (p=0.5).however we found more ipsilateral breast tumor recurrence in hormone negativetumors (p=0.002), high grade tumors (p=0.021), young age (p=0.017) and lymph nodepositive cases (p=0.011). we observed no significant difference between n1 and n2lymph node status (p=0.241).conclusion: our data suggest that breast-conserving surgery with r0 resection isfeasible in stage iiia cases whenever cosmetic appearance can be maintained as longas surgery will be followed by radiotherapy and chemotherapy. a prospective study withlarger numbers is recommended for further evaluation of this issue.