چکیده (انگلیسی):

Background: Breast conserving surgery (BCS) after neoadjuvant chemotherapy (NC) in patients with
locally advanced breast cancer (LABC) is an infrequent procedure. In these patients the association with
BCS and oncoplastic surgery (OS) is reported as a possible procedure in case-series, but there are limited
case-control studies.
Methods: A matched case-control study evaluated LABC submitted to NC and BCS. We evaluated 78
patients submitted to doxorubicin-cyclophosphamide regimen followed by paclitaxel regimen. The
match case-control proportion was 2:1 and the patients were selected by tumor size, clinical T stage and
year of diagnosis.
Results: 52 underwent classic BCS and 26 OS. The average size tumor was 5.25 cm and 88.5% of the
tumors were larger than 3 cm. The clinical and pathological group characteristics were similar, except the
weight of surgical specimens (p ¼ 0.004), and surgical margins (p ¼ 0.06), which were higher in OS
group. The rate of complete pathologic response was 26.9%. 97.4% received postoperative radiotherapy. At
67.1 months of follow up, 10.2% had local recurrence (LR) and 12.8% locoregional recurrence (LRR) and
19.2% died because disease progression. The overall survival at 60 months was 81.7%. After surgery the
disease free-survival at 60 months was 76.5%. The was no difference between groups related to pathologic
response (p ¼ 0.42), LR (p ¼ 0.71), LRR (p ¼ 1.00), overall survival (p ¼ 0.99) and disease specific
survival (p ¼ 0.87).
Conclusion: This study corroborates the fact that OS is a safety procedure for LABC, offering the similar
oncologic results observed in patients submitted to classic BCS.