caa a22 4500 445336110 CHVBK 20180317142755.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1390-8 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1390-8 Impact of Progression During Neoadjuvant Chemotherapy on Surgical Management of Breast Cancer [Elektronische Daten] [Abigail Caudle, Ana Gonzalez-Angulo, Kelly Hunt, Lajos Pusztai, Henry Kuerer, Elizabeth Mittendorf, Gabriel Hortobagyi, Funda Meric-Bernstam] Background: Although neoadjuvant chemotherapy (NCT) is standard therapy for locally advanced breast cancer, it remains controversial for early-stage disease due to concerns that disease progression may make breast-conservation therapy (BCT), or even operability, impossible. The goal of this study was to determine the impact of disease progression during NCT on surgical management. Methods: We reviewed clinicopathological data on patients who received NCT for stage I-III breast cancer from 1994 to 2007. Chemotherapy regimens were anthracycline- and/or taxane-based as determined by the treating medical oncologist. Results: Of 1,928 patients who received NCT, 1,762 (91%) had a partial or complete response, 107 (6%) had stable disease (SD), and 59 (3%) progressed (PD) while receiving at least one regimen. Of the patients with progressive disease, 40 (68%) patients underwent mastectomy, 12 (20%) underwent BCT, and 7 (12%) did not undergo surgery. In patients who underwent mastectomy, only three (8%) were BCT candidates before progression. Overall, disease progression changed the operative plan in 11 (0.5%) patients: 3 developed distant metastasis, 2 developed clinical lymphadenopathy, 3 required mastectomy instead of BCT, 2 became inoperable, and 1 required flap closure. Conclusions: Disease progression while receiving NCT is infrequent (3%), but early identification may allow for change to other, potentially beneficial, therapeutic interventions. Patients with breast cancer who receive NCT should be evaluated frequently for response to therapy. Overall, progression during NCT changes the surgical management in a small proportion of patients. Society of Surgical Oncology, 2010 Caudle Abigail Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Gonzalez-Angulo Ana Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Hunt Kelly Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Pusztai Lajos Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Kuerer Henry Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Mittendorf Elizabeth Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Hortobagyi Gabriel Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Meric-Bernstam Funda Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 932-938 1068-9265 18:4<932 2011 18 10434 https://doi.org/10.1245/s10434-010-1390-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1390-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Caudle Abigail Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Gonzalez-Angulo Ana Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Hunt Kelly Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Pusztai Lajos Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Kuerer Henry Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Mittendorf Elizabeth Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Hortobagyi Gabriel Department of Breast Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Meric-Bernstam Funda Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 932-938 1068-9265 18:4<932 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer