Open AccessANALYSIS OF PATIENTS WITH LOCALLY ADVANCED BREAST CANCER TREATED AT ICESP
Author(s) -
Gabriela Bezerra Nobrega,
Bruna Salani Mota,
Gabriela Boufélli de Freitas,
Jonathan Yugo Maesaka,
Rodrigo Gonçalves,
Sérgio Mitsuo Masili Oku,
Angela Francisca Trinconi da Cunha,
José Roberto Filassi
Publication year - 2021
Publication title -
mastology
Language(s) - English
Resource type - Conference proceedings
eISSN - 2594-5408
pISSN - 2594-5394
DOI - 10.29289/259453942021v31s2076
Subject(s) - breast cancer , medicine , hazard ratio , proportional hazards model , oncology , retrospective cohort study , chemotherapy , neoadjuvant therapy , surgery , cancer , gynecology , confidence interval
Objective: The aim of this study was to assess the oncological efficacy of breast-conserving surgery (BCS) after neoadjuvant therapy (NT) in patients with invasive locally advanced breast cancer (LABC). Methodology: A retrospective cohort study was conducted at the Instituto do Cancer de São Paulo Octavio Frias de Oliveira (ICESP), with LABC (Stages IIb– III) treated with NT between 2010 and 2015. The endpoints were disease-free survival (DFS), local disease-free survival (LDFS), overall survival (OS), and residual tumor volume, considering pathological complete response (PCR) as ypT0 ypN0. The multivariable analyses were performed by using the Cox proportional hazard models. Results: In this study, 529 patients were included. The mean age was 52.7 (51.53–53.90). All patients were submitted to NT, i.e., 95.5% was submitted to neoadjuvant chemotherapy and 4.5%, hormone therapy. The mean follow-up was 62.33 (60.01–64.65) months. The PCR was identified in 12.7%. The BCS was performed in 24.6% (130) patients versus 75.4% (399) of mastectomies (MTs). There were no differences in 13% versus 9.2% (95%CI; p=0.2) LDFS for MT and BCS. The DFS was lower at 55.4% in the MT group versus 77.7% in the BCS group (95%CI; p30 (RR1.8; 95%CI 1.331–2.618; p=0.000). The type of surgery had no impact on mortality (RR 1.47; 95%CI 0.945–2.298; p=0.08). Conclusion: In our population, the BCS does not affect the LDFS rates and mortality, which seems to be safe to perform in patients who desire to conserve the breast after neoadjuvant treatment. PCR, clinical stage, and Ki67 had an important impact on mortality.