e11532 Background: Neoadjuvant chemotherapy (NCT) is a reasonable option for operable breast cancer in terms of downsizing large tumor and increasing the rate of breast-conserving surgery (BCS). However, BCS in patients with large breast tumors down-staged by NCT remains still controversial because of the possibility of residual tumor and resistance to NCT. Aims of this study were to evaluate the long-term survival results of patients who received NCT and BCS compared to patients who received BCS first and to compare recurrence and survival rates between patients who received preplanned BCS and those who received down-staged BCS among patients who underwent NCT. Methods: Between 2000 and 2007, 70 patients with clinical stage III breast cancer who received BCS after NCT (NCT group) and 72 patients with clinical stage III breast cancer who underwent BCS first (Surgery group) were retrospectively reviewed. Among 70 patients received NCT, 45 patients (64.3%) received preplanned BCS (preplanned BCS group) and 25 patients (35.7%) received down-staged BCS (down-staged BCS group). The long-term results including ipsilateral breast tumor recurrence (IBTR), locoregional recurrence (LRR), disease recurrence and survival rates were compared with groups. Results: There was no significant difference in IBTR-free survival, LRR-free survival rates, disease-free survival and overall survival rates between the NCT and the Surgery group (p=0.971, p=0.294, p=0.863 and p=0.933, respectively). Among patients who received NCT, IBTR-free survival, LRR-free survival, disease-free survival and overall survival rates was not also different between the preplanned BCS group and the down-staged BCS group (p=0.278, p=0.501, p=0.776 and p=0.412, respectively). Conclusions: Our study demonstrated that patients who received BCS after NCT showed similar long-term resutls compared to patients who received BCS first in clinical stage III breast cancer patients. Also, down-staged BCS shows is oncologically as safe as preplanned BCS in clinical stage III breast cancer patients in terms of recurrence and survival.
