TITLE:
Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience
AUTHORS:
Yasser El Ghamrini, Ahmed Morad, Hossam Elsadek, Ahmed Ezzat
KEYWORDS:
Locally Advanced Breast Cancer, Oncoplastic Surgery, Oncological Safety, Neoadjuvant Chemotherapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.11,
November
28,
2017
ABSTRACT: Background: Integration of neoadjuvant
chemotherapy (NCT) in early 70s resulted that many LABC tumors become
resectable but with total mastectomy especially those with partial response,
oncoplastic techniques give better oncological outcome with better cosmetic
results. Objective: We evaluate the oncological safety of oncoplastic
breast surgery (OS) in LABC showing partial response to NCT. Methods: We
prospectively analyzed the data of 32 out of 58 patients with LABC who showed
partial response to NCT and could have conservative
surgery with advanced oncoplastic techniques rather than total mastectomy. Results: Out of 58
patients with LABC, received neoadjuvant chemotherapy, complete response
was observed in 8 patients (13%), partial response reported in 32 (55.1%)
cases, 12 patients (20%) had stable disease and 6 patients (10%) showed
progressive disease. Data of 32 cases were studied (mean age 44.84 ± 9.10
years; range 26 - 59 years). Inferior pedicle was performed in 9 cases, mini LD flap in 3
patients, 5 had Grissotti technique, 6 with superomedial pedicle, 4 had V mammoplasty and 3 with J
mammoplasty and 2 had vertical mammoplasty. Margins were positive in 5
cases (15.6%) with mean margin width 9.63 ± 5.72 (range 0 - 22 mm), and the local recurrence was reported in 2 cases (6.2%). Complications
were reported in 3 cases (9.3%). The follow up was 1.67 ± 1.03 (range 0 - 3.3 years). Conclusions: Integration of neoadjuvant chemotherapy together with advanced oncoplastic
techniques opens a new way for management of LABC especially
those showing partial response with avoidance of total mastectomy, and comparable oncological safety in addition to better aesthetic and psychological outcome.