Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPCARRARA, Guilherme Freire AngottiSCAPULATEMPO-NETO, CristovamABRAHAO-MACHADO, Lucas FariaBRENTANI, Maria MitziNUNES, Joao SoaresFOLGUEIRA, Maria Aparecida Azevedo KoikeVIEIRA, Rene Aloisio da Costa2017-06-092017-06-092017CLINICS, v.72, n.3, p.134-142, 20171807-5932https://observatorio.fm.usp.br/handle/OPI/20019OBJECTIVE: To evaluate ipsilateral breast tumor recurrence after breast-conserving surgery for locally advanced breast cancer. METHODS: A retrospective observational cohort study was performed in patients with locally advanced breast cancer submitted to breast-conserving surgery after neoadjuvant chemotherapy based on an adriamycin-cyclophosphamide- paclitaxel regimen. We evaluated the clinical, pathologic, immunohistochemistry, and surgical factors that contribute to ipsilateral breast tumor recurrence and locoregional recurrence. A Kaplan-Meier analysis and Cox model were used to evaluate the main factors related to disease-free survival. RESULTS: Of the 449 patients who received neoadjuvant chemotherapy, 98 underwent breast-conserving surgery. The average diameter of the tumors was 5.3 cm, and 87.2% reached a size of up to 3 cm. Moreover, 86.7% were classified as clinical stage III, 74.5% had T3-T4 tumors, 80.5% had N1-N2 axilla, and 89.8% had invasive ductal carcinoma. A pathologic complete response was observed in 27.6% of the tumors, and 100.0% of samples had free margins. The 5-year actuarial overall survival rate was 81.2%, and the mean follow-up was 72.8 months. The rates of ipsilateral breast tumor recurrence and locoregional recurrence were 11.2% and 15.3%, respectively. Multifocal morphology response was the only factor related to ipsilateral breast tumor recurrence disease-free survival (p=0.04). A multivariate analysis showed that the pathologic response evaluation criteria in solid tumors (RECIST)-breast cutoff was the only factor related to locoregional recurrence disease-free survival (p=0.01). CONCLUSIONS: Breast-conserving surgery is a safe and effective therapy for selected locally advanced breast tumors.engopenAccessBreast NeoplasmsNeoadjuvant TherapyDrug Therapy CombinationBreast-Conserving SurgeryRecurrenceDisease-Free Survivalsurgical adjuvant breastpreoperative chemotherapyconservation therapyradical-mastectomystage-iicarcinomametaanalysisfeasibilitypredictswomenarticleCopyright HOSPITAL CLINICAS, UNIV SAO PAULO10.6061/clinics/2017(03)02Medicine, General & Internal1980-5322