Despite the widespread use of organ-sparing operations (OSO) in patients with early breast cancer (BC), their performance for Stage IIB, IIIA, or IIIC BC opens to be debated.

OBJECTIVE

To study the possibility of performing of OSO in patients with locally advanced BC with due regard for the efficiency of neoadjuvant polychemotherapy (NAPCT).

SUBJECTS AND METHODS

In 2013 to 2020, the investigators analyzed the medical records of 55 patients with IIB, IIIA, or IIIC BC who underwent OSO at the second stage of combination treatment after NAPCT in the Department of Oncology and Reconstructive Plastic Surgery for Cancer of the Breast and Its Skin, P.A. Herzen Moscow Oncological Research Institute. The distribution of patients by stages was as follows: IIB (in 67.3%), IIIA (in 9.3%), and IIIC (in 26.3%).

RESULTS

Among the 100 patients with BC (cT₁-3N₀-3M₀), 55 subjects with its Stages IIB, IIIA, or IIIC were candidates for radical mastectomy before NAPCT. However, preoperative polychemotherapy caused positive clinical changes as partial (32/58.2%) and complete (12/21.8%) resorption of a tumor node and affected regional lymph nodes, in this connection it became possible to perform OSS in this patient group. The “no tumor on ink” standard approach demonstrated high 3- and 5-year recurrence-free survival rates; the recurrence rate during 7-year follow-up was 1.8%. The recurrence-free survival rates were 98.5% and 98.5% at 3 and 5 years; the 3- and 5-year overall survival rates were 89.6% and 84.9%, respectively.

CONCLUSION

Thus, the study established that organ-sparing operations after NAPCT in patients with Stage IIB, IIIA, or IIIC BC are safe from an oncological point of view when positive changes are achieved during the treatment.