1. High rates of breast conservation for large ductal and lobular invasive carcinomas combining multimodality strategies.
- Author
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Bollet MA, Savignoni A, Pierga JY, Lae M, Fourchotte V, Kirova YM, Dendale R, Campana F, Sigal-Zafrani B, Salmon R, Fourquet A, and Vincent-Salomon A
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Invasiveness, Prognosis, Radiotherapy, Adjuvant, Survival Rate, Breast Neoplasms therapy, Carcinoma, Ductal, Breast therapy, Carcinoma, Lobular therapy, Mastectomy, Segmental, Neoadjuvant Therapy
- Abstract
The literature reports low rates of breast conservation after neoadjuvant chemotherapy for operable breast cancers not amenable to initial breast-conserving surgery. This study aims to compare the outcome of lobular vs ductal carcinomas after neoadjuvant chemotherapy. Between 1989 and 1999, 750 patients with clinical stage II/IIIA ductal (672) or lobular (78) invasive breast carcinomas were treated at the Institut Curie with primary anthracycline-based polychemotherapy followed by either breast conservation (surgery and/or radiotherapy) or mastectomy. Median follow-up was 10 years. Clinical response to primary chemotherapy was significantly worse for lobular than for ductal carcinomas (47 vs 60%; P=0.04), but only histological grade remained predictive in multivariate analysis. Breast conservation was high for both ductal and lobular carcinomas (65 and 54%; P=0.07), due, in part, to the use of radiotherapy, either exclusive or preoperative, for respectively 26 and 40% of patients. The lobular type had no adverse effect, neither on locoregional control nor on overall survival, even in the group of patients treated with breast conservation.
- Published
- 2008
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