PMID- 33259649
OWN - NLM
STAT- MEDLINE
DCOM- 20210304
LR  - 20210304
IS  - 1096-9098 (Electronic)
IS  - 0022-4790 (Linking)
VI  - 123
IP  - 2
DP  - 2021 Feb
TI  - Evaluating the effect of neoadjuvant chemotherapy on surgical outcomes after 
      breast conserving surgery.
PG  - 439-445
LID - 10.1002/jso.26301 [doi]
AB  - BACKGROUND: Neoadjuvant chemotherapy (NAC) increases breast-conserving surgery 
      (BCS) rates with comparable locoregional control and survival outcomes to 
      adjuvant therapy. More women are receiving NAC and achieving pathologic complete 
      responses (pCR). This study sought to evaluate the effect of NAC on surgical 
      outcomes after the adoption of a "no-ink-on-tumor" margin policy in patients 
      undergoing primary BCS (PBSC). METHODS: An IRB approved database was queried for 
      women undergoing BCS for invasive breast cancer after March 2014. We compared 
      patients who underwent NAC followed by BCS versus PBCS. Demographic, tumor, 
      treatment, and outcome variables were compared using both univariate and 
      multivariable analysis. RESULTS: A total of 162 patients were evaluated. NAC 
      patients had significantly lower re-excision rates (0% NAC vs. 9% PBCS, p = .03), 
      margin positivity (0% NAC vs. 5% PBCS, p = .01), and greater patient satisfaction 
      with breast cosmesis (97 NAC vs. 77 PBCS, p = .01). On multivariable analysis, 
      NAC was not an independent predictor of lower final resection volume, total 
      complications, or greater satisfaction with breasts when controlling for age and 
      T category at diagnosis. CONCLUSION: NAC followed by BCS may offer less margin 
      positivity, lower re-excision rates, and greater patient satisfaction when 
      compared to a contemporary PBCS cohort in the "no-ink-on-tumor" era.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Woeste, Matthew R
AU  - Woeste MR
AUID- ORCID: 0000-0001-5594-2888
AD  - Division of Surgical Oncology, Department of Surgery, University of Louisville 
      School of Medicine, Louisville, Kentucky, USA.
FAU - Bhutiani, Neal
AU  - Bhutiani N
AUID- ORCID: 0000-0002-6288-2788
AD  - Division of Surgical Oncology, Department of Surgery, University of Louisville 
      School of Medicine, Louisville, Kentucky, USA.
FAU - Donaldson, Marilyn
AU  - Donaldson M
AD  - Division of Surgical Oncology, Department of Surgery, University of Louisville 
      School of Medicine, Louisville, Kentucky, USA.
FAU - McMasters, Kelly M
AU  - McMasters KM
AD  - Division of Surgical Oncology, Department of Surgery, University of Louisville 
      School of Medicine, Louisville, Kentucky, USA.
FAU - Ajkay, Nicolas
AU  - Ajkay N
AD  - Division of Surgical Oncology, Department of Surgery, University of Louisville 
      School of Medicine, Louisville, Kentucky, USA.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20201201
PL  - United States
TA  - J Surg Oncol
JT  - Journal of surgical oncology
JID - 0222643
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Receptors, Progesterone)
RN  - EC 2.7.10.1 (ERBB2 protein, human)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Breast Neoplasms/drug therapy/pathology/*surgery
MH  - Carcinoma, Ductal, Breast/drug therapy/pathology/*surgery
MH  - Carcinoma, Lobular/drug therapy/pathology/*surgery
MH  - Chemotherapy, Adjuvant
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Margins of Excision
MH  - Mastectomy, Segmental/*methods
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Neoplasm Staging
MH  - Receptor, ErbB-2/metabolism
MH  - Receptors, Estrogen/metabolism
MH  - Receptors, Progesterone/metabolism
MH  - Treatment Outcome
OTO - NOTNLM
OT  - breast cancer
OT  - lumpectomy
OT  - margins
OT  - neoadjuvant chemotherapy
EDAT- 2020/12/02 06:00
MHDA- 2021/03/05 06:00
CRDT- 2020/12/01 17:10
PHST- 2020/08/20 00:00 [received]
PHST- 2020/10/27 00:00 [revised]
PHST- 2020/11/05 00:00 [accepted]
PHST- 2020/12/02 06:00 [pubmed]
PHST- 2021/03/05 06:00 [medline]
PHST- 2020/12/01 17:10 [entrez]
AID - 10.1002/jso.26301 [doi]
PST - ppublish
SO  - J Surg Oncol. 2021 Feb;123(2):439-445. doi: 10.1002/jso.26301. Epub 2020 Dec 1.