Progress of Breast-Conserving Surgery after Neoadjuvant Chemotherapy for Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Guang ,  WANG Yongsheng.

Breast Cancer Center, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China;

Corresponding author：

WANG Yongsheng., Email: wangysh2008@yahoo.com.cn

Keywords：

Breast cancer; Neoadjuvant chemotherapy; Breast-conserving surgery; Tumor shrinking model

Video：

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Objective To explore the tumor shrinking model, the accurate image evaluation of the residual tumor, and the selection criteria for breast-conserving surgery after neoadjuvant chemotherapy. Methods To review literature on the clinical, imaging, and pathologic study of breast cancer after neoadjuvant chemotherapy. Results The possibility of breast-conserving for patients with large primary tumor is enhanced with neoadjuvant chemotherapy. The tumor shrinking mode after neoadjuvant chemotherapy and its correlation factors are still unclear. MRI is the most accurate image evaluation of the residual tumor at present. M.D.Anderson prognostic index and the American National Cancer Institute selection criteria for breast-conserving surgery after neoadjuvant chemotherapy are helpful for selection of surgical type. Conclusion Tumor shrinking mode and its accurate image evaluation is a key to the selection of breast-conserving surgery and the control of local recurrence after neoadjuvant chemotherapy, and is the research direction in future.

Citation： LIU Guang,WANG Yongsheng.. Progress of Breast-Conserving Surgery after Neoadjuvant Chemotherapy for Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1249-1252. doi: Copy

1.	Goldhirsch A, Ingle JN, Gelber RD, et al. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009 [J]. Ann Oncol, 2009; 20(8): 1319-1329.
2.	Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Clin Oncol, 1997; 15(7): 2483-2493.
3.	Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 [J]. J Clin Oncol, 2008; 26(5): 778-785.
4.	van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 [J]. J Clin Oncol, 2001; 19(22): 4224-4237.
5.	Yuan Z, Qu X, Zhang ZT, et al. Neoadjuvant chemotherapy in patients with stages Ⅱ and Ⅲ breast cancer [J]. Chin Med J (Engl), 2009; 122(24): 2993-2997.
6.	Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Natl Cancer Inst Monogr, 2001; 30: 96-102.
7.	Asoglu O, Muslumanoglu M, Igci A, et al. Breast conserving surgery after primary chemotherapy in locally advanced breast cancer [J]. Acta Chir Belg, 2005; 105(1): 62-68.
8.	Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonié Bordeaux Groupe Sein (IBBGS) [J]. Ann Oncol, 1999; 10(1): 47-52.
9.	Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
10.	Cebrecos I, Córdoba O, Deu J, et al. Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy? [J]. Eur J Surg Oncol, 2010; 36(6): 528-534.
11.	李金峰, 欧阳涛, 王天峰, 等. 局部进展期及较大乳腺癌的保乳治疗 [J]. 中华外科杂志, 2005; 43(15): 1008-1010.
12.	Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis [J]. J Natl Cancer Inst, 2005; 97(3): 188-194.
13.	Mieog JS, van der Hage JA, van de Velde CJ. Preoperative chemotherapy for women with operable breast cancer [J]. Cochrane Database Syst Rev, 2007; (2): CD005002.
14.	Hortobagyi GN, Ames FC, Buzdar AU, et al. Management of stage Ⅲ primary breast cancer with primary chemotherapy, surgery, and radiation therapy [J]. Cancer, 1988; 62(12): 2507-2516.
15.	Rajan R, Poniecka A, Smith TL, et al. Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response [J]. Cancer, 2004; 100(7): 1365-1373.
16.	Akazawa K, Tamaki Y, Taguchi T, et al. Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy [J]. Breast J, 2006; 12(2): 130-137.
17.	Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab [J]. Ann Surg Oncol, 2009; 16(6): 1619-1628.
18.	Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI [J]. Acta Oncologica, 2007; 46(7): 996-1003.
19.	Peintinger F, Kuerer HM, McGuire SE, et al. Residual specimen cellularity after neoadjuvant chemotherapy for breast cancer [J]. Br J Surg, 2008; 95(4): 433-437.
20.	El-Didi MH, Moneer MM, Khaled HM, et al. Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management [J]. Surg Today, 2000; 30(3): 249-254.
21.	谭云山, 陈君雪, 纪元, 等. 乳腺癌新辅助化疗后残留癌组织的病理分析 [J]. 中国临床医学, 2000; 7(1): 58-60.
22.	Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
23.	Warren RM, Bobrow LG, Earl HM, et al. Can breast MRI help in the management of women with breast cancer treated by neoadjuvant chemotherapy? [J]. Br J Cancer, 2004; 90(7): 1349-1360.
24.	Straver ME, Loo CE, Rutgers EJ, et al. MRI-model to guide the surgical treatment in breast cancer patients after neoadjuvant chemotherapy [J]. Ann Surg, 2010; 251(4): 701-707.
25.	Yamashiro N, Tozaki M, Ogawa T, et al. Preoperative MRI marking technique for the planning of breast-conserving surgery [J]. Breast Cancer, 2009; 16(3): 223-228.
26.	Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy [J]. Cancer, 2008; 112(1): 17-26.
27.	Garimella V, Qutob O, Fox JN, et al. Recurrence rates after DCE-MRI image guided planning for breast-conserving surgery following neoadjuvant chemotherapy for locally advanced breast cancer patients [J]. Eur J Surg Oncol, 2007; 33(2): 157-161.
28.	Bhattacharyya M, Ryan D, Carpenter R, et al. Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer [J]. Br J Cancer, 2008; 98(2): 289-293.
29.	Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy [J]. Eur Radiol, 2003; 13(6): 1213-1223.
30.	Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
31.	Morris EA. Review of breast MRI: indications and limitations [J]. Semin Roentgenol, 2001; 36(3): 226-237.
32.	Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002; 347(16): 1233-1241.
33.	Sadetzki S, Oberman B, Zipple D, et al. Breast conservation after neoadjuvant chemotherapy [J]. Ann Surg Oncol, 2005; 12(6): 480-487.
34.	Rouzier R, Mathieu MC, Sideris L, et al. Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors [J]. Cancer, 2004; 101(5): 918-925.
35.	Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience [J]. J Clin Oncol, 2004; 22(12): 2303-2312.
36.	Newman LA, Buzdar AU, Singletary SE, et al. A prospective trial of preoperative chemotherapy in resectable breast cancer: predictors of breast-conservation therapy feasibility [J]. Ann Surg Oncol, 2002; 9(3): 228-234.
37.	Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy [J]. Cancer, 2005; 103(4): 689-695.
38.	Huang EH, Strom EA, Perkins GH, et al. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score [J]. Int J Radiat Oncol Biol Phys, 2006; 66(2): 352-357.
39.	Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
40.	Alm El-Din MA, Taghian AG. Breast conservation therapy for patients with locally advanced breast cancer [J]. Semin Radiat Oncol, 2009; 19(4): 229-235.

1. Goldhirsch A, Ingle JN, Gelber RD, et al. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009 [J]. Ann Oncol, 2009; 20(8): 1319-1329.
2. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Clin Oncol, 1997; 15(7): 2483-2493.
3. Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 [J]. J Clin Oncol, 2008; 26(5): 778-785.
4. van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 [J]. J Clin Oncol, 2001; 19(22): 4224-4237.
5. Yuan Z, Qu X, Zhang ZT, et al. Neoadjuvant chemotherapy in patients with stages Ⅱ and Ⅲ breast cancer [J]. Chin Med J (Engl), 2009; 122(24): 2993-2997.
6. Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Natl Cancer Inst Monogr, 2001; 30: 96-102.
7. Asoglu O, Muslumanoglu M, Igci A, et al. Breast conserving surgery after primary chemotherapy in locally advanced breast cancer [J]. Acta Chir Belg, 2005; 105(1): 62-68.
8. Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonié Bordeaux Groupe Sein (IBBGS) [J]. Ann Oncol, 1999; 10(1): 47-52.
9. Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
10. Cebrecos I, Córdoba O, Deu J, et al. Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy? [J]. Eur J Surg Oncol, 2010; 36(6): 528-534.
11. 李金峰, 欧阳涛, 王天峰, 等. 局部进展期及较大乳腺癌的保乳治疗 [J]. 中华外科杂志, 2005; 43(15): 1008-1010.
12. Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis [J]. J Natl Cancer Inst, 2005; 97(3): 188-194.
13. Mieog JS, van der Hage JA, van de Velde CJ. Preoperative chemotherapy for women with operable breast cancer [J]. Cochrane Database Syst Rev, 2007; (2): CD005002.
14. Hortobagyi GN, Ames FC, Buzdar AU, et al. Management of stage Ⅲ primary breast cancer with primary chemotherapy, surgery, and radiation therapy [J]. Cancer, 1988; 62(12): 2507-2516.
15. Rajan R, Poniecka A, Smith TL, et al. Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response [J]. Cancer, 2004; 100(7): 1365-1373.
16. Akazawa K, Tamaki Y, Taguchi T, et al. Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy [J]. Breast J, 2006; 12(2): 130-137.
17. Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab [J]. Ann Surg Oncol, 2009; 16(6): 1619-1628.
18. Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI [J]. Acta Oncologica, 2007; 46(7): 996-1003.
19. Peintinger F, Kuerer HM, McGuire SE, et al. Residual specimen cellularity after neoadjuvant chemotherapy for breast cancer [J]. Br J Surg, 2008; 95(4): 433-437.
20. El-Didi MH, Moneer MM, Khaled HM, et al. Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management [J]. Surg Today, 2000; 30(3): 249-254.
21. 谭云山, 陈君雪, 纪元, 等. 乳腺癌新辅助化疗后残留癌组织的病理分析 [J]. 中国临床医学, 2000; 7(1): 58-60.
22. Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
23. Warren RM, Bobrow LG, Earl HM, et al. Can breast MRI help in the management of women with breast cancer treated by neoadjuvant chemotherapy? [J]. Br J Cancer, 2004; 90(7): 1349-1360.
24. Straver ME, Loo CE, Rutgers EJ, et al. MRI-model to guide the surgical treatment in breast cancer patients after neoadjuvant chemotherapy [J]. Ann Surg, 2010; 251(4): 701-707.
25. Yamashiro N, Tozaki M, Ogawa T, et al. Preoperative MRI marking technique for the planning of breast-conserving surgery [J]. Breast Cancer, 2009; 16(3): 223-228.
26. Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy [J]. Cancer, 2008; 112(1): 17-26.
27. Garimella V, Qutob O, Fox JN, et al. Recurrence rates after DCE-MRI image guided planning for breast-conserving surgery following neoadjuvant chemotherapy for locally advanced breast cancer patients [J]. Eur J Surg Oncol, 2007; 33(2): 157-161.
28. Bhattacharyya M, Ryan D, Carpenter R, et al. Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer [J]. Br J Cancer, 2008; 98(2): 289-293.
29. Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy [J]. Eur Radiol, 2003; 13(6): 1213-1223.
30. Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
31. Morris EA. Review of breast MRI: indications and limitations [J]. Semin Roentgenol, 2001; 36(3): 226-237.
32. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002; 347(16): 1233-1241.
33. Sadetzki S, Oberman B, Zipple D, et al. Breast conservation after neoadjuvant chemotherapy [J]. Ann Surg Oncol, 2005; 12(6): 480-487.
34. Rouzier R, Mathieu MC, Sideris L, et al. Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors [J]. Cancer, 2004; 101(5): 918-925.
35. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience [J]. J Clin Oncol, 2004; 22(12): 2303-2312.
36. Newman LA, Buzdar AU, Singletary SE, et al. A prospective trial of preoperative chemotherapy in resectable breast cancer: predictors of breast-conservation therapy feasibility [J]. Ann Surg Oncol, 2002; 9(3): 228-234.
37. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy [J]. Cancer, 2005; 103(4): 689-695.
38. Huang EH, Strom EA, Perkins GH, et al. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score [J]. Int J Radiat Oncol Biol Phys, 2006; 66(2): 352-357.
39. Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
40. Alm El-Din MA, Taghian AG. Breast conservation therapy for patients with locally advanced breast cancer [J]. Semin Radiat Oncol, 2009; 19(4): 229-235.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress of Breast-Conserving Surgery after Neoadjuvant Chemotherapy for Breast Cancer

Abstract Full text Figures/Tables Video References Cited by

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