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 is an important issue after neoadjuvant treatment. On the other hand, retrospective data suggest that breast-conserving surgery is feasible up to stage IIIA breast cancer without preoperative therapy.Methods: We retrospectively analyzed ۱۶۴ patients who underwent breastconserving surgery followed by adjuvant chemotherapy and/or endocrinal therapy with whole breast radiation between ۲۰۰۵ and ۲۰۱۲. Of those, ۱۱۶ patients had stages I and II (group ۱) breast cancer, whereas ۴۸ patients had stage IIIA (group ۲).Results: After a median follow-up of ۴۰.۴ months, ۱۸ (۱۵.۵%) patients in group- ۱and ۸ (۱۶.۶%) in group-۲ developed ipsilateral breast tumor recurrence (P=۰.۷۷). Mean time to tumor recurrence was ۱۹ months in group ۱ and ۱۷ months in group ۲ (P=۰.۵). However we found more ipsilateral breast tumor recurrence in hormone negative tumors (P=۰.۰۰۲), high grade tumors (P=۰.۰۲۱), young age (P=۰.۰۱۷) and lymph node positive cases (P=۰.۰۱۱). We observed no significant difference between N۱ and N۲ lymph node status (P=۰.۲۴۱).Conclusion: Our data suggest that breast-conserving surgery with R۰ resection is feasible in stage IIIA cases whenever cosmetic appearance can be maintained as long as surgery will be followed by radiotherapy and chemotherapy. A prospective study with larger numbers is recommended for further evaluation of this issue.