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Breast-conserving treatment after neoadjuvant chemotherapy in large breast cancer


Several recent trials have demonstrated that neoadjuvant chemotherapy can allow more patients to successfully undergo breast-conserving treatment (BCT), and does not confer a survival disadvantage compared with standard adjuvant chemotherapy. In addition, the pathological response of primary breast tumors to neoadjuvant chemotherapy appears to be a surrogate marker for patient outcome.

In our series, during the period from May 1995 to December 2000, 86 patients with tumors between 3.1 and 6.0 cm in diameter received epirubicin-based neoadjuvant chemotherapy. There were 55 (64.0%) responders and ultimately 64 patients (74.4%) were treated with BCT. The margin positive rate was 14.1% (9/64), similar to the rate after BCT for early-stage breast cancers, the largest diameter of which was smaller than 3 cm. At a median follow-up of 30 months, only 3 patients in the BCT group have developed local recurrence; the local recurrence rate appears to be comparable to that after BCT for early stage breast cancers. Long term follow-up is required, however, to establish whether this procedure is a safe alternative to mastectomy for patients with large breast cancers.

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Author information

Correspondence to Hideo Inaji or Yoshifumi Komoike or Kazuyoshi Motomura or Tsutomu Kasugai or Yuka Sawai or Masahiko Koizumi or Takayuki Nose or Hiroki Koyama.

Additional information

Reprint requests to Hideo Inaji, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.

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Inaji, H., Komoike, Y., Motomura, K. et al. Breast-conserving treatment after neoadjuvant chemotherapy in large breast cancer. Breast Cancer 9, 20 (2002).

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Key words

  • Breast cancer
  • Neoadjuvant chemotherapy
  • Breast-conserving treatment
  • Local recurrence