ASO Visual Abstract: Assessing Interobserver Variability of Cosmetic Outcome Assessment in Breast Cancer Patients Undergoing Breast Conservation Surgery

Abstract Background: Neoadjuvant chemotherapy (NAC) has been the standard treatment for locally advanced breast cancer for the purpose of downstaging or for conversion from mastectomy to breast conservation surgery (BCS). There is still a high locoregional recurrence (LRR) rate after NAC. The aim of this study was to determine predictive factors for locoregional recurrence (LRR) in breast cancer patients after NAC. Materials and Methods: Between 2005 and 2017, 1047 breast cancer patients underwent BCS or mastectomy after NAC in Chang Gung Memorial Hospital, Linkou. We obtained data regarding patient and tumor characteristics, chemotherapy regimens, clinical tumor response, tumor subtypes and pathological complete response (pCR), type of surgery, and recurrence.Results: The median follow-up time was 45.1 months (range 0.1-160.3 months). The mean initial tumor size was 4.89 cm (SD ±2.95 cm). Of the 1047 NAC patients, 232 (22.2%) achieved pCR. The BCS and mastectomy rates were 41% and 59%, respectively. Overall, 240 patients experienced tumor recurrence (22.9%). Thirty-five cases of LRR (14.3%) were noted following BCS, of which 4.3% achieved pCR. Multivariate analysis indicated that independent factors for the prediction of LRR included hormone receptor negative/human epidermal growth factor receptor 2 positive (HR-/HER2+) subtype, HR-/HER2- subtype, and failure to achieve pCR. Further investigation according to the molecular subtype showed that following BCS, HR-/HER2+ non-pCR group had significantly increased LRR compared with the HR+/HER2+ pCR group (22.2% vs 6.3%, p<0.05), and the HR-/HER2-non-pCR group had significantly increased LRR compared with the HR-/HER2-pCR group (0% vs 20.4%, p<0.005). Conclusion: Pathological response after NAC is related to the risk of developing LRR. The LRR rate was higher in non-pCR patients after NAC, especially in hormone receptor-negative patients undergoing BCS. Therefore, both the pathological response status and molecular subtype should be carefully considered when considering candidates for BCS after NAC.

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Clinical significance following breast conservation surgery with or without postoperative irradiation in Japanese women with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11530 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11530-e11530

Author(s):

Kentaro Tamaki ◽

Nobumitsu Tamaki ◽

Yoshihiko Kamada ◽

Kanou Uehara ◽

Minoru Miyashita ◽

...

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Triple Negative ◽

Breast Conservation ◽

Surgical Margin ◽

Breast Conservation Surgery ◽

Breast Cancer Patients ◽

Conservation Surgery ◽

Postoperative Irradiation

e11530 Background: Postoperative irradiation or radiotherapy following breast conservation surgery has been reported to be clinically effective in terms of prevention of local breast cancer recurrences. However, it is also true that its local recurrence rate was only 5% to 10%, suggestive of the lack of its clinical benefits in the great majority of the cases. The purpose of this study was to investigate the significance of post-operative radiotherapy in breast conservation surgery by comparing the groups with or without irradiation. Methods: We retrospectively evaluated 1197 Japanese female breast cancer patients (598 irradiation cases and 599 non-irradiation cases). Radiation was administered in a dose of 50 Gy for all conserved breast and additional 10 Gy in those with positive margins or carcinoma within 5mm from surgical margin. We examined the local recurrence rates in those with or without post-operative irradiation according to the status of surgical margin, ER and HER2 in breast cancer tissues. Results: RFS in the irradiated groups were significantly higher than non-irradiated ones in surgical margin positive (P=0.001, HR: 0.334, 95%CI: 0.14-0.79), negative (P=0.015, 0.362, 95%CI: 0.15-0.82), ER positive (P<0.001, HR: 0.249, 95%CI: 0.11-0.54), HER2 negative (P=0.002, HR: 0.316, 95%CI: 0.15-0.65) and non-triple negative patients (P=0.001, HR: 0.382, 95%CI: 0.21-0.69). However, no significant differences were detected between these two groups in ER negative (P=0.288, HR: 0.586, 95%CI: 0.22-1.57), HER2 positive (P=0.969, HR: 0.971, 95%CI: 0.22-4.24) and triple negative (P=0.336, HR: 0.282, 95%CI: 0.02-3.72) patients. Conclusions: Results of our present study could provide clinically inert information as to the selection of the breast cancer patients following conserve surgery.

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Higher locoregional recurrence in hormone receptor-negative breast cancer patients with residual disease after neoadjuvant treatment undergoing breast conservation surgery

10.21203/rs.3.rs-41619/v1 ◽

2020 ◽

Author(s):

Hsu-Huan Chou ◽

Wei-Shan Chung ◽

Rong-Yao Ding ◽

Wen-Ling Kuo ◽

Chi-Chang Yu ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormone Receptor ◽

Locoregional Recurrence ◽

Molecular Subtype ◽

Breast Conservation ◽

Pathological Response ◽

Breast Conservation Surgery ◽

Breast Cancer Patients ◽

Conservation Surgery

Abstract Background Neoadjuvant chemotherapy (NAC) has been the standard treatment for locally advanced breast cancer for the purpose of downstaging or for conversion from mastectomy to breast conservation surgery (BCS). Locoregional recurrence (LRR) rate is still high after NAC. The aim of this study was to determine predictive factors for locoregional recurrence (LRR) in breast cancer patients in association with the operation types after NAC. Methods Between 2005 and 2017, 1047 breast cancer patients underwent BCS or mastectomy after NAC in Chang Gung Memorial Hospital, Linkou. We obtained data regarding patient and tumor characteristics, chemotherapy regimens, clinical tumor response, tumor subtypes and pathological complete response (pCR), type of surgery, and recurrence. Results The median follow-up time was 45.1 months (range 0.1-160.3 months). The mean initial tumor size was 4.89 cm (SD ± 2.95 cm). Of the 1047 NAC patients, 232 (22.2%) achieved pCR. The BCS and mastectomy rates were 41% and 59%, respectively. Overall, 240 patients experienced tumor recurrence (22.9%). Thirty-five cases of LRR (14.3%) were noted following BCS, of which 4.3% achieved pCR. Multivariate analysis indicated that independent factors for the prediction of LRR included hormone receptor negative/human epidermal growth factor receptor 2 positive (HR-/HER2+) subtype, HR-/HER2- subtype, and failure to achieve pCR. Further investigation according to the molecular subtype showed that following BCS, HR-/HER2 + non-pCR group had significantly increased LRR compared with the HR+/HER2 + pCR group (22.2% vs 6.3%, p < 0.05), and the HR-/HER2-non-pCR group had significantly increased LRR compared with the HR-/HER2-pCR group (0% vs 20.4%, p < 0.005). Conclusion Pathological response after NAC is related to the risk of developing LRR. The LRR rate was higher in non-pCR patients after NAC, especially in hormone receptor-negative patients undergoing BCS. Therefore, both the pathological response status and molecular subtype should be carefully considered when considering candidates for BCS after NAC.

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