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Attaining pathological complete regression for breast conservation - A pilot experience in a developing country.

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This study achieved 100% pathological complete regression (PCR) in breast cancer patients using combined surgery and chemotherapy, significantly improving breast conservation rates. Extended chemotherapy and re-excisions were key to these enhanced results.

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Breast conservationCancerPathologic complete remission(PCR)

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Local recurrence is a significant risk in breast conservation therapy for breast cancer.
  • Pathological complete regression (PCR) after chemotherapy correlates with reduced recurrence rates.
  • Previous studies reported lower PCR rates, necessitating improved therapeutic strategies.

Purpose of the Study:

  • To evaluate the success rates of achieving pathological complete regression (PCR) in breast conservation for non-metastatic breast cancer.
  • To assess the clinical outcomes associated with this approach in a developing country setting.

Main Methods:

  • Patients with early-stage breast cancer received sequential anthracycline/taxane-based neoadjuvant/adjuvant chemotherapy.
  • Surgical excision was followed by re-excisions after initial chemotherapy cycles.
  • Further re-excisions were performed for incomplete pathological regression after additional chemotherapy.

Main Results:

  • Pathological complete regression (PCR) was achieved in 100% of assessed cases (18/20), aligning with clinical complete response.
  • The study included a range of tumor sizes (0.5-9 cm) and types, including invasive ductal and lobular carcinomas.
  • Median follow-up was 48 months, with two recorded demises.

Conclusions:

  • Extended chemotherapy cycles combined with re-excisions successfully achieved high rates of pathological complete remission (100%).
  • This approach enhances breast conservation rates, even for larger tumors (T3 and T4).
  • The study reports significantly higher PCR rates compared to previous findings.