Feasibility of Breast Conserving Surgery in Stage IIIA Breast Carcinoma Patients in the Absence of Neoadjuvant Therapy

Preoperative determination of the extent of viable residual tumor is an important issue after neoadjuvant treatment. On the other hand, retrospective data suggest that breast-conserving surgery is feasible up to stage IIIA breast cancer without preoperative therapy. We retrospectively analyzed 164 patients who underwent breastconserving surgery followed by adjuvant chemotherapy and/or endocrinal therapy with whole breast radiation between 2005 and 2012. Of those, 116 patients had stages I and II (group 1) breast cancer, whereas 48 patients had stage IIIA (group 2). After a median follow-up of 40.4 months, 18 (15.5%) patients in group- 1and 8 (16.6%) in group-2 developed ipsilateral breast tumor recurrence (P=0.77). Mean time to tumor recurrence was 19 months in group 1 and 17 months in group 2 (P=0.5). However we found more ipsilateral breast tumor recurrence in hormone negative tumors (P=0.002), high grade tumors (P=0.021), young age (P=0.017) and lymph node positive cases (P=0.011). We observed no significant difference between N1 and N2 lymph node status (P=0.241). Our data suggest that breast-conserving surgery with R0 resection is feasible in stage IIIA cases whenever cosmetic appearance can be maintained as long as surgery will be followed by radiotherapy and chemotherapy. A prospective study with larger numbers is recommended for further evaluation of this issue.