Feasibility of breast conservation after neoadjuvant taxene based chemotherapy in locally advanced breast cancer: a Prospective Phase I trial

Forty five patients had stage IIB (except those with T2N1 disease) and stage IIIA were selected to 3 cycles taxane-based neoadjuvant chemotherapy. Patient who had tumours ≤5 cm underwent a tentative BCS while patients who had tumour size >5 cm underwent radical surgery. Negative margin is essential for BCS. Adjuvant chemotherapy and 3-D radiotherapy ± hormonal treatment were given to all patients.Thirty four patients had BCS. Response to chemotherapy was the only statistically significant factor which influences the BCS. Incidence of local recurrence was 5.9% for patients who had BCS at a median follow up 24 months.Breast conservation is feasible in selected cases of locally advanced, non metastatic cancer breast. We recommend that patients who have tumour size ≤4 cm after chemotherapy are the best candidates for BCS.Long-term survival is common among women with locally advanced breast cancer; therefore, quality of life issues become vitally important. For most women, loss of a breast is emotionally disturbing [1].The patient's response to preoperative chemotherapy is a powerful prognostic factor in predicting disease-free and overall survival from locally advanced breast cancer [2,3]. By assessing the response to preoperative chemotherapy, it is possible to select out a better prognosis group of patients who will have improved long-term survival and a low rate of local recurrence. Therefore, patients who respond to preoperative chemotherapy are often the best candidates for breast conservation, allowing for less disfigurement with preservation of function [3,4].Several studies have documented the feasibility and safety of breast conservation for locally advanced breast cancer after preoperative chemotherapy. Breast conservation is possible in 27% to 90% of patients after preoperative chemotherapy [4,5]. Local recurrence rates after breast conservation are low (5% - 10%) in patients who respond to preoperative chemotherapy [6,7].Our primary outcome was the evaluatio