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e-Article

High rates of breast conservation for large ductal and lobular invasive carcinomas combining multimodality strategies.
Document Type
Journal Article
Source
British Journal of Cancer. 2/26/2008, Vol. 98 Issue 4, p734-741. 8p. 7 Charts.
Subject
*BREAST cancer surgery
*BREAST surgery
*COMBINATION drug therapy
*CANCER treatment
*CANCER invasiveness
*DRUG therapy
Language
ISSN
0007-0920
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. [ABSTRACT FROM AUTHOR]