Preoperative chemotherapy decreases the need for re-excision of breast cancers between 2 and 4 cm diameter.

Authors

• Carla J Christy
• David Thorsteinsson
• Baiba J Grube
• Dalliah Black
• Maysa Abu-Khalaf
• Gina G Chung
• Michael P DiGiovanna
• Kenneth Miller
• Susan A Higgins
• Joanne Weidhaas
• Lyndsay Harris
• Fattaneh A Tavassoli
• Donald R Lannin

Publication/Presentation Date

3-1-2009

Abstract

INTRODUCTION: It is accepted that preoperative chemotherapy can result in increased breast preservation for breast cancers greater than 4 cm. The benefits of preoperative chemotherapy are less clear, however, for patients who present with smaller tumors and are already candidates for breast-preserving surgery. The goal of this study is to assess the effect of preoperative chemotherapy on breast cancers between 2 and 4 cm diameter.

METHODS: A retrospective chart review was conducted of patients diagnosed with new breast cancer at the Yale-New Haven Breast Center for the years 2002-2007. Patients were included in the study if their breast cancer was between 2 and 4 cm and their initial surgical treatment had been completed. Patients with distant metastases were excluded.

RESULTS: There were 156 new cancers that met study requirements. Forty-seven patients underwent preoperative chemotherapy, and 109 patients had their surgery first, usually followed by chemotherapy. Initial surgery was lumpectomy for 31 out of 47 patients (66%) in the preoperative chemotherapy group compared with 62 out of 109 patients (57%) in the surgery group. For patients with lumpectomies, 2 out of 31 patients (6%) in the preoperative group had positive margins and required re-excision compared with 20 out of 62 patients (37%) in the surgery-first group (P< 0.01).

CONCLUSIONS: We conclude that, for tumors between 2 and 4 cm, preoperative chemotherapy is associated with a significantly decreased rate of re-excision following lumpectomy. This not only results in fewer mastectomies, but also avoids the morbidity and inferior cosmetic results associated with a re-excision lumpectomy.

Volume

16

Issue

3

First Page

697

Last Page

702

ISSN

1534-4681

Published In/Presented At

Christy, C. J., Thorsteinsson, D., Grube, B. J., Black, D., Abu-Khalaf, M., Chung, G. G., DiGiovanna, M. P., Miller, K., Higgins, S. A., Weidhaas, J., Harris, L., Tavassoli, F. A., & Lannin, D. R. (2009). Preoperative chemotherapy decreases the need for re-excision of breast cancers between 2 and 4 cm diameter. Annals of surgical oncology, 16(3), 697–702. https://doi.org/10.1245/s10434-008-0268-5

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

19132447

Department(s)

Administration and Leadership

Document Type

Article