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Annals of Surgical Oncology

, Volume 19, Issue 2, pp 519–526 | Cite as

Neoadjuvant Chemotherapy Increases the Rate of Breast Conservation in Lobular-Type Breast Cancer Patients

  • Florian FitzalEmail author
  • Martina Mittlboeck
  • Guenther Steger
  • Rupert Bartsch
  • Margaretha Rudas
  • Peter Dubsky
  • Otto Riedl
  • Raimund Jakesz
  • Michael Gnant
Breast Oncology

Abstract

Introduction

Our study aims to determine whether patients with lobular-type breast cancer have significantly improved rates of breast conservation (BCT) after neoadjuvant chemotherapy (nCT).

Methods

Patients who received nCT and surgery within three prospective trials between 1995 and 2007 at the Medical University of Vienna were retrospectively analyzed.

Results

325 patients had median follow-up of 53 months; 21% had lobular cancer, and 70% of these women were initially scheduled for mastectomy (MX). Twenty-one finally received BCT, yielding a MX–BCT turnover rate of 45%. Of patients primarily scheduled for BCT, 20% had to finally undergo MX in lobular cancer. The 256 patients with ductal-type breast cancer finally had a MX–BCT turnover rate of 52% (p = 0.561 versus lobular) and a BCT–MX turnover rate of 15% (p = 0.933 versus lobular). Secondary MX after initial BCT was necessary in 2% (ductal) and 10% (lobular, p = 0.110). There was no difference in local recurrence in lobular- as compared with ductal-type breast cancer patients after BCT (2.7% versus 10%, p = 0.135), nor was a difference seen in lobular breast cancer patients when comparing BCT with MX (2.7% versus 3.4%, p = 0.795). Tumor type was not an independent predictor for either BCT or local recurrence.

Conclusion

We do not suggest excluding patients with lobular-type breast cancer who are primarily scheduled for MX from nCT, since BCT rates may still increase by 45% without influencing the oncologic outcome.

Keywords

Breast Cancer Breast Cancer Patient Sentinel Node Biopsy Inflammatory Breast Cancer Pegfilgrastim 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

The authors are grateful to Natalija Frank for her dedicated work on patients and building up the database, and to Karl Thomanek for language improvement.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Florian Fitzal
    • 1
    Email author
  • Martina Mittlboeck
    • 2
  • Guenther Steger
    • 3
  • Rupert Bartsch
    • 3
  • Margaretha Rudas
    • 4
  • Peter Dubsky
    • 1
  • Otto Riedl
    • 1
  • Raimund Jakesz
    • 1
  • Michael Gnant
    • 1
  1. 1.Department of Surgery, Breast Health Care CenterMedical University of ViennaViennaAustria
  2. 2.Department of Clinical Biometrics, Breast Health Care CenterMedical University of ViennaViennaAustria
  3. 3.Department of Oncology, Breast Health Care CenterMedical University of ViennaViennaAustria
  4. 4.Department of Pathology, Breast Health Care CenterMedical University of ViennaViennaAustria

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