95 P - Preoperative, neoadjuvant chemotherapy leads to breast conserving surgery in locally advanced breast cancer

Abstract

Conservation of the breast is one of the major goals of modern breast cancer surgery. Very large tumors (T3/T4) or those with unfavorable localization remained subject to mastectomy until recently. Thus, we evaluated the impact of preoperative chemotherapy on the reduction of tumor size and the subsequent possibility of breast conserving surgery in patients with locally advanced breast cancer. We report on 48 patients suffering from biopsy proven breast cancer, who would have been treated with mastectomy when conventional criteria would have been applied. These patients were treated with preoperative cytotoxic chemotherapy using the CMF or FEC regimen. Study end points were clinical and pathological response rates and the surgical method which could be applied at the end of the preoperative treatment. Overall in 41 out of 48 patients (85%), we observed an objective response 6 patients (13%) had a complete pathological response at the time of their operation and 35 patients (73%) experienced a partial response (i.e. > 50% shrinkage of tumor). 7 patients had stable disease and no patient progressed during the preoperative therapy period. 33 patients (69%) could have a breast conserving procedure, and only 15 (31%) had to undergo mastectomy. Thus, preoperative chemotherapy appears to be a valuable tool in the treatment of large breast cancers in order to allow breast conserving surgery in a substantial number of patients with T3/T4-tumors. It remains to be determined, whether the neoadjuvant treatment approach to breast cancer leads also to a reduced relapse rate or a prolongation of survival.