Surgery Post Neoadjuvant Therapy for Breast Cancer: An Analysis of 82 Patients Treated at a Specialist Unit in Johannesburg
Van Schalkwyk, L.; Benn, C.; Bergstrom, K.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie 55(3): 75
2017
ISSN/ISBN: 0038-2361 PMID: 28876590 Document Number: 692592
Neoadjuvant therapy in the breast cancer setting not only provides an indication of response to systemic therapy, but also results in tumour downsizing/downstaging, which facilitates breast conservation therapy (BCT). The aim of this retrospective analysis is to examine the surgical management of patients who have received neoadjuvant therapy for breast cancer at the Netcare Breast Care Centre (NCBC) in Johannesburg. All breast cancer patients managed surgically at the NCBC after neoadjuvant chemotherapy/primary endocrine therapy were identified from a database of 431 breast cancer patients presenting to this facility from June 2015 to June 2016. Patients with incomplete information were excluded. Demographic information, tumour characteristics and details regarding surgical management were collected and analysed. Seventy-two female patients with a median age of 48 years (range 24-75 years) were included in the analysis. The majority (68/72, 94.4%) had invasive ductal carcinoma. Stage at presentation was stage I in 16 patients (16/72, 22.2%) stage II in 31 patients (31/72 43.1%) and stage III in 25 patients (25/72, 34.7%). Pathologic complete response to neoadjuvant therapy was observed in 31 patients (31/72, 43.1%), partial response in 32 patients (32/72, 44.4%) and poor response in 7 patients (7/72, 9.7%). More than half (49/72, 68.1%) of the patients had BCT. Seventeen of the BCT patients (17/49, 34.7%) had initially presented with locally advanced (stage III) disease. BCT is feasible in a significant proportion of patients treated with neoadjuvant therapy for breast cancer.