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SURGICAL OUTCOMES IN NEO‐ADJUVANT CHEMOTHERAPY FOR INFLAMMATORY AND LOCALLY ADVANCED BREAST CANCER EOVER 5 YEARS OF SINGLE INSTITUTION EXPERIENCE
Author(s) -
Dean T. L.,
Pitcher M.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04913_12.x
Subject(s) - medicine , breast cancer , surgery , mastectomy , cancer , pathological , inflammatory breast cancer , disease , chemotherapy , adjuvant therapy , stage (stratigraphy) , retrospective cohort study , medical record , adjuvant chemotherapy , paleontology , biology
Purpose: Examination of short and long term surgical outcomes and degree of pathological response in breast cancer patients who have undergone neo‐adjuvant chemotherapy surgery at Western Health from March 2003 – December 2008. Methods: retrospective analysis of prospectively maintained breast cancer database as well as examination of medical records, pathology and radiology reports. 28 of the 535 patients in the database met criteria for inclusion. Results: 26/28 underwent mastectomy and axillary dissection +/− immediate reconstruction. Pathological response – 7.1% had no residual disease, 10.7% had in situ disease only. A reduction in maximum diameter of > 50% was found in 35.7%. 18.8% were minimally or unresponsive. The degree of clinical response did not correlate reliably with degree of pathological response. Wound infection was seen in 100% smokers and 19% non‐smokers. 4 patients had evidence of metastatic disease at presentation. 5 of the remaining 24 (20.8%) developed distant metastases. 4/28 suffered loco‐regional recurrence during the study period. 4/28 patients died from their disease, 50% of whom had extensive metastases at diagnosis. Follow up range 6–69 months, average follow up 32 months. We found a relationship between post neo‐adjuvant chemotherapy AJCC stage and survival. Conclusions: Neo‐adjuvant chemotherapy prior to surgery allows good local control and safe reconstruction in locally advanced and inflammatory breast cancer. Smoking cessation should be encouraged prior to surgery to decrease post operative morbidity due to wound complications. Continued follow up of this group would allow examination of and 10 year outcomes.