Breast-conserving surgery (BCS) followed by an adjuvant radiation therapy (RT) and chemotherapy is considered the preferred approach in patients with I-II stage breast cancer . If radiation is effective anticancer treatment modalities why it used after removing of breast cancer?
Objective: To analyze the results of BCS in breast cancer patients (pts) who underwent the neoadjuvant chemo-radiation treatment.
Methods. In the retrospective study were involved 36 women with primary breast cancer of stage T1 (19 pts) and T2 (18 pts). Molecular subtypes: luminal A – 16 pts, luminal B – 5, HER2-neu – 8, triple negative – 7 pts. Treatment scheme: neo-adjuvant radiation- or chemo-radiation therapy, BCS with axillary lymph node dissection, postoperative radiation- / chemo- / hormonal therapy was depending of histological finding, age, hormonal status, and risk factors. RT (Terabalt-100, Co-60): neoadjuvant whole-breast irradiation 30–35 Gy/ 2.6-2.9 Gy per daily fraction or 5 Gy per fraction × 5 days. Results. There were no serious postop wound complications. The grade 1-2 arm lymphedema occur in 3 (8%) pts. Slight breast edema and grade 1 radiodermatitis was observed in half of the pts. Cosmetic appearance of the breast was good and satisfactory a few months after surgery. Reoperation due to a local recurrence was done in two cases (5.5%). 4 (11%) pts died 2-4 years after surgery due to metastatic disease. 5-years overall survival rate was 89 %.
Conclusions. BCS can be safely performed after neo-adjuvant chemo- and radiation therapy. Preoperative RT of breast cancer is safe and does not impact significantly on postoperative wound complications.
Key words: breast cancer, neoadjuvant radiotherapy, breast-conserving surgery.