Is breast-conserving surgery for patients with locally advanced breast cancer who have undergone neoadjuvant therapy associated with a better survival rate?

Authors

  • Gabriela Bezerra Nobrega Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • Bruna Salani Mota Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • Gabriela Boufelli de Freitas Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • Jonathan Yugo Maesaka Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • Rodrigo Goncalves Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • José Roberto Piato Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.
  • José Roberto Filassi Setor de Mastologia, DivisÃo de Ginecologia, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brazil.

DOI:

https://doi.org/10.29289/259453942023V33S1041

Keywords:

breast neoplasms, neoadjuvant therapy, local disease, mastectomy, survival rate

Abstract

Objective: It is known that breast-conserving surgery (BCS) is oncologically safe for breast cancer after neoadjuvant
treatment (NAT). Besides that, recent data imply better overall survival in early breast cancer, but it remains uncertain
in locally advanced breast cancer (LABC). The aim of this study was to compare the superiority of the BCS on LABC after
NAT when compared with mastectomy (MS). Methodology: It is a single-center retrospective cohort study on 530 patients
with LABC who received NAT and underwent surgery, BCS or MS, between 2010 and 2015. Outcomes: Overall survival
(OS), disease-free survival (DFS), and local disease-free survival (LDFS). Results: We included 530 patients with a median
follow-up of 79 months. From these, 24.6% underwent BCS and 75.4% MS. BCS has a higher pathological complete response
rate than MS, 22.3% vs. 10%, p<0.001, respectively. About distant recurrence rates, BCS was 15.4% and MS 36.8% with OR
0.298; 95%CI 0.177–0.504. The local recurrence rates were 9.2% and 9.5% with OR 0.693; 95%CI 0.347–1.383 for BCS and MS,
respectively. The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p=0.000). In OS multivariate analysis,
MS had a worse predictive value (OR 1.678; 95%CI 1.069–2.635; p=0.024) when compared with BCS. Conclusion: We concluded that BCS presents a better OS than mastectomy on LABC after NAT, improving OS by 32%.

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Published

2026-03-12

How to Cite

Nobrega, G. B., Mota, B. S., Freitas, G. B. de, Maesaka, J. Y., Goncalves, R., Piato, J. R., & Filassi, J. R. (2026). Is breast-conserving surgery for patients with locally advanced breast cancer who have undergone neoadjuvant therapy associated with a better survival rate?. Mastology, 33(suppl.1). https://doi.org/10.29289/259453942023V33S1041

Issue

Vol. 33 No. suppl.1 (2023)

Section

E-poster

License

Copyright (c) 2026 Gabriela Bezerra Nobrega, Bruna Salani Mota, Gabriela Boufelli de Freitas, Jonathan Yugo Maesaka, Rodrigo Goncalves, José Roberto Piato, José Roberto Filassi

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.