THE MODERN ASPECTS OF THE BREAST CONSERVING SURGERY AFTER NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH BREAST CANCER CT1-3N0-3M0

Abstract

Introduction. While the “no tumor on ink” approach is generally accepted for breast-conserving surgery (BCS) in patient with breast cancer, it remains unclear whether it is oncologically safe for BCS after neoadjuvant chemotherapy therapy (NACT). The aim of the study is to investigate the optimal width of the resection edges in BCS after NALT and the influence on disease-free and overall survival in patients with breast cancer. Materials and methods. Retrospectively, the medical documentation of 76 patients with breast cancer, who were performed BCS after NACT, was studied. The distribution by stage of breast cancer was as follows: I St. -5 patients, II St. - 55, III St. - 16 (excluded IIIB St.). Invasive cancer of non-specific type was diagnosed in 81.6% of cases, in 6.5% - lobular cancer, in 1.3% - combined breast cancer. Radical breast resections in the classic version were performed in 28 cases, and oncoplastic resections in various modifications were performed in 48 Cases. Results. We present the retrospective data of 76 patients with breast cancer who underwent OSA after NALT in the Department of breast and skin cancer OF the Moscow Institute of medical research. P. A. Herzen. The results of our study demonstrated the oncological safety of OSO with respect to new sizes of tumor nodes after NALT followed by remote radiotherapy. The method of “absence of tumor cells” at the edges of resection demonstrated a high percentage of 1, 3, 5-year relapse - free and overall survival, the frequency of relapse was 2.6%. There was no statistically significant difference in 1, 3, 5-year relapse-free and overall survival when the width of the resection edges was more or less than 1 mm. Conclusion. The results of numerous studies have demonstrated that the breast- conserving surgery is the safe method of surgical treatment from an oncological point of view and is an alternative for radical mastectomies for patients with the breast cancer after neoadjuvant chemotherapy.