PR48 CLOSED SURGICAL MARGINS WERE STILL PREDICTOR OF IBTR ON LABCS AFTER PRIMARY SYSTEMIC CHEMOTHERAPY AND MASTECTOMY

Abstract

Background: The current study identified determinants of systemic recurrence and ipsilateral breast tumor recurrence (IBTR) in patients with locally advanced breast carcinoma (LABC) treated with neoadjuvant chemotherapy and mastectomy. Methods: The study population consisted of 200 consecutive women with stages locally advanced breast carcinoma who underwent mastectomy after neoadjuvant chemotherapy between July 2009-July 2011. Clinical and pathologic characteristics evaluated included age, tumor size, tumor grade, estrogen and progesterone receptor status, surgical margins, axillary lymph node involvement, and use of adjuvant radiotherapy. Results: At a median follow-up time of 2 years, 42% had developed an ipsilateral breast tumor recurrence (IBTR), and 18% had developed a systemic recurrence. On multivariate logistic regression analysis, tumor size greater than 5 cm, positive lymph nodes, lack of adjuvant radiotherapy, triple negative type and closed margins (odds ratio [OR], 3.8; 95% confidence interval [CI],1.1-12.3; P = 0.033) were predictors of IBTR. When IBTR was added into the model, IBTR was dependent predictor of systemic recurrence. Conclusions: Positive surgical margins and biology molecular type of breast cancer are predictors of systemic recurrence and IBRT after primary systemic chemotherapy and mastectomy on LABCs. Aggressive local therapy is necessary to ensure adequate surgical margins and to minimize IBTR.