OBJECTIVE

To assess long-term treatment results in breast cancer patients with skin edema and an incomplete response to neoadjuvant drug therapy.

Subjects and methods. The study enrolled 182 breast cancer patients with skin edema and an incomplete response to neoadjuvant drug treatment. The patients were divided into 3 groups: 1) 91 patients who had undergone surgery followed by external beam radiation therapy (EBRT); 2) 41 who had received radiation therapy according to a radical program without subsequent surgery; 3) 50 patients who had induction radiation therapy followed by surgery.

RESULTS

The overall 10-year survival rates in Group 1 were better than those in Group 3 (47.8% vs 20.7%; p=0.017). There was also a tendency to increase the survival rate when comparing the indicators of Groups 1 and 2 (47.8% vs 38.2%; p=0.081). Analysis of relapse-free survival showed statistically significant differences over a 5-year follow-up period between Groups 1 and 2 (54.7% vs 40.7%; p=0.032). During a 10-year follow-up period, there was a trend towards an increase in indicators (50.2% vs 23.8%; p=0.06). The 5-year locoregional recurrence-free survival was also significantly better in Group 1 than in Group 3 (87.6% vs 74.7%). During a 10-year follow-up period, there is also a tendency to increase this survival rate at 10 years in Groups 1 and 3 (85% vs 74.7%; p=0.078), as well as at similar time in Group 1 and 2 (85% vs 72.3%; p=0.085). The distant metastasis-free survival rates was statistically significantly higher only at a 5-year follow-up period in Group 1 than in Group 3 (58.4% vs 41.0%; p=0.05).

CONCLUSION

The investigation has demonstrated that persistent skin edema should not be an obstacle to surgical intervention. An integrated approach (neoadjuvant drug therapy followed by surgery and EBRT) has shown the greatest effectiveness in the treatment of these patients.