Comparative study between conservative breast surgery and modified radical mastectomy in T3 & T4 breast cancer after neo adjuvant chemotherapy
Yasser Amer, Mahmoud Aboamra, Ibrahem Sabry, Ahmed M Hassan, Khaled Monazea
Objective: To study the comparison between breast conservative surgery (CBS) and modified radical mastectomy (MRM) as regard recurrence, metastasis and death in T3 & T4 breast cancer after neo-adjuvant chemotherapy. Patients and methods: This prospective study was done on 60 patients diagnosed to have locally advanced breast cancer (LABC) received neo-adjuvant chemotherapy randomized into two groups, 30 of them managed by CBS and 30 managed by MRM, and followed up for one years. The preoperative assessment and investigation were done for all patients that underwent the operation. Results: there is significant difference as regard the age between the two groups. 76.7% of patients were diagnosed by tru-cut needle biopsy and 23.3% of patients were diagnosed by incisional biopsy. 1.7% of patients have well differentiated tumours G1, 71.7% of patients have moderately differentiated tumours G2 and 26.7% of patients have poorly differentiated tumours G3. 76.7% of patients were diagnosed by incisional biopsy. 66.7% of patients have T3 lesion and 33.3% of patients have T4 lesion. 71.7% of patients had IDC, 13.3% of patients had IL and 15% of patients had other. 15% of patients had N0, 35% of patients had N1, 38.3% of patients had N2 and 11.7% of patients have N3. ER was +ve in 70% of CBS patients and 73.3% in MRM patients. PR was +ve in 63.3% of CBS patients, and 66.7% of MRM patients, and HER2 was +ve in 40.9%, and PR was +ve in 31.4% of breast cancer patients. After one year follow up 10% of patients of CBS had recurrence and in 3.3% of patients of MRM had recurrence. Metastasis was found in 6.7% in CBS patients and 6.7% in MRM patients. Death occurs in 3.3% in CBS patients and 6.7% in MRM patients. Conclusions: No difference in survival, recurrence and death between CBS and MRM in patients with LABC after neo adjuvant chemotherapy, postoperative chemotherapy and radiotherapy (RTH). So for young patient who is aiming for breast conservative and have LABC we recommend neo adjuvant chemotherapy followed by CBS and post-operative chemotherapy.
Yasser Amer, Mahmoud Aboamra, Ibrahem Sabry, Ahmed M Hassan, Khaled Monazea. Comparative study between conservative breast surgery and modified radical mastectomy in T3 & T4 breast cancer after neo adjuvant chemotherapy. International Journal of Multidisciplinary Research and Development, Volume 4, Issue 7, 2017, Pages 493-496