De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy
Background: Neoadjuvant therapy (NAT) has become increasingly employed for the treatment of cT3-4 breast cancer (BC), enabling breast-conserving surgery (BCS) in cases traditionally considered for mastectomy. This study aims to identify predictors for breast conservation post-NAT and to evaluate whe...
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| Format: | Article |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/6/1169 |
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| author | Corrado Tinterri Erika Barbieri Andrea Sagona Alberto Bottini Giuseppe Canavese Damiano Gentile |
| author_facet | Corrado Tinterri Erika Barbieri Andrea Sagona Alberto Bottini Giuseppe Canavese Damiano Gentile |
| author_sort | Corrado Tinterri |
| collection | DOAJ |
| description | Background: Neoadjuvant therapy (NAT) has become increasingly employed for the treatment of cT3-4 breast cancer (BC), enabling breast-conserving surgery (BCS) in cases traditionally considered for mastectomy. This study aims to identify predictors for breast conservation post-NAT and to evaluate whether BCS influences long-term oncological outcomes. Methods: We retrospectively analyzed data from patients with cT3-4 BC who received NAT at the Breast Unit of IRCCS Humanitas Research Hospital, Milan, Italy, from October 2009 to April 2020. Surgical outcomes and long-term oncological results, such as disease-free survival (DFS), distant DFS (DDFS), overall survival (OS), and BC-specific survival (BCSS), were compared between the BCS and mastectomy groups. Results: Among 114 patients analyzed, 37 (32.5%) underwent BCS, and 77 (67.5%) had a mastectomy. The key predictors for opting for BCS included absence of vascular invasion, reduced tumor size post-NAT, and achieving ypT0 status. No significant differences in DFS, DDFS, OS, and BCSS were observed between the two surgical groups (log-ranks, <i>p</i> = 0.520, <i>p</i> = 0.789, <i>p</i> = 0.216, <i>p</i> = 0.559, respectively). Conclusions: BCS after NAT is a feasible and safe option for patients with cT3-4 BC, without adversely affecting long-term oncological outcomes. Identifying predictors of breast conservation can guide surgical decision-making, ensuring that patients receive optimal treatment. |
| first_indexed | 2024-04-24T18:27:51Z |
| format | Article |
| id | doaj.art-53b54f8389bb4c70b9b6c3efa4799816 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-24T18:27:51Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-53b54f8389bb4c70b9b6c3efa47998162024-03-27T13:30:01ZengMDPI AGCancers2072-66942024-03-01166116910.3390/cancers16061169De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with MastectomyCorrado Tinterri0Erika Barbieri1Andrea Sagona2Alberto Bottini3Giuseppe Canavese4Damiano Gentile5Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBreast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBreast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBreast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBreast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBreast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyBackground: Neoadjuvant therapy (NAT) has become increasingly employed for the treatment of cT3-4 breast cancer (BC), enabling breast-conserving surgery (BCS) in cases traditionally considered for mastectomy. This study aims to identify predictors for breast conservation post-NAT and to evaluate whether BCS influences long-term oncological outcomes. Methods: We retrospectively analyzed data from patients with cT3-4 BC who received NAT at the Breast Unit of IRCCS Humanitas Research Hospital, Milan, Italy, from October 2009 to April 2020. Surgical outcomes and long-term oncological results, such as disease-free survival (DFS), distant DFS (DDFS), overall survival (OS), and BC-specific survival (BCSS), were compared between the BCS and mastectomy groups. Results: Among 114 patients analyzed, 37 (32.5%) underwent BCS, and 77 (67.5%) had a mastectomy. The key predictors for opting for BCS included absence of vascular invasion, reduced tumor size post-NAT, and achieving ypT0 status. No significant differences in DFS, DDFS, OS, and BCSS were observed between the two surgical groups (log-ranks, <i>p</i> = 0.520, <i>p</i> = 0.789, <i>p</i> = 0.216, <i>p</i> = 0.559, respectively). Conclusions: BCS after NAT is a feasible and safe option for patients with cT3-4 BC, without adversely affecting long-term oncological outcomes. Identifying predictors of breast conservation can guide surgical decision-making, ensuring that patients receive optimal treatment.https://www.mdpi.com/2072-6694/16/6/1169breast cancerneoadjuvant therapybreast-conserving surgerymastectomyde-escalation |
| spellingShingle | Corrado Tinterri Erika Barbieri Andrea Sagona Alberto Bottini Giuseppe Canavese Damiano Gentile De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy Cancers breast cancer neoadjuvant therapy breast-conserving surgery mastectomy de-escalation |
| title | De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy |
| title_full | De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy |
| title_fullStr | De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy |
| title_full_unstemmed | De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy |
| title_short | De-Escalation Surgery in cT3-4 Breast Cancer Patients after Neoadjuvant Therapy: Predictors of Breast Conservation and Comparison of Long-Term Oncological Outcomes with Mastectomy |
| title_sort | de escalation surgery in ct3 4 breast cancer patients after neoadjuvant therapy predictors of breast conservation and comparison of long term oncological outcomes with mastectomy |
| topic | breast cancer neoadjuvant therapy breast-conserving surgery mastectomy de-escalation |
| url | https://www.mdpi.com/2072-6694/16/6/1169 |
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