Zhu Yuan1, Xiang Qu, Zhong-Tao Zhang, Yu Wang. 1. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Abstract
BACKGROUND: Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy. METHODS: This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer. The patients in Group 1 (n = 54) were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 (n = 43) initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed. RESULTS: Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II (P = 0.034) and 0% to 12.6% in stage III (P = 0.016), and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II (P = 0.046) and 28.1% to 8.1% in stage III (P = 0.026). After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 (68.4% vs 31.2%, P = 0.028, and 63.2% vs 25.0%, P = 0.024, respectively). There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 (85.7% vs 85.2%, P = 0.953, and 80.6% vs 74.1%, P = 0.400, respectively). CONCLUSIONS: Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in stage III disease. However, neoadjuvant chemotherapy did not confer greater survival on stage II disease.
BACKGROUND: Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy. METHODS: This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer. The patients in Group 1 (n = 54) were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 (n = 43) initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed. RESULTS: Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II (P = 0.034) and 0% to 12.6% in stage III (P = 0.016), and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II (P = 0.046) and 28.1% to 8.1% in stage III (P = 0.026). After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 (68.4% vs 31.2%, P = 0.028, and 63.2% vs 25.0%, P = 0.024, respectively). There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 (85.7% vs 85.2%, P = 0.953, and 80.6% vs 74.1%, P = 0.400, respectively). CONCLUSIONS: Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in stage III disease. However, neoadjuvant chemotherapy did not confer greater survival on stage II disease.