Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience

Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19). Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4). Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80) months. Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients. Amac: Lokal ileri evre meme kanserinde neoadjuvan kemoterapi ile hastalar meme koruyucu cerrahi olma sansini yakalayabilmektedir. Bu yazida lokal ileri evre meme kanseri nedeni neoadjuvan kemoterapi sonrasi meme koruyucu cerrahi,aksiler diseksiyon ve sentinel lenf nodu orneklemesi yapilmis hastalarin sonuclari degerlendirilmistir. Gerec ve Yontemler: Bu calismaya 2002-2009 yillari arasinda evre IIIA ve IIIB lokal ileri evre meme kanserli 12 hasta alinmistir. Hastalara cerrahi oncesi antrasiklin bazli kemoterapi rejimleri uygulanmistir. Level 2 aksiller lenf nodu diseksiyonu oncesi sentinel lenf nodu orneklemesi, meme koruyucu cerrahi ve sonrasinda radyoterapi yapilmistir. Bulgular: Hastalarin besi evre IIIA, altisi IIIB ve biri evre IIIB idi.Hastalara 3-6 kur arasi FAC/FEC rejimleri uygulandi. 8 hastada kismi, 4a#39;unde tam yanit alindi. Aksiller diseksiyon yapilan hastalarin 5a#39;inde pozitif lenf nodu goruldu. Lenf nodu ortanca degeri 12 (n:8-19) idi. Bes hastaya sentinel lenf nodu orneklemesi yapildi.Bir hastada sentinel lenf nodu goruntulenemedi. Diseke edilen sentinel lenf nodu ortanca degeri 3,5 (n:3-4) idi. Hicbir hastada lokoregional nuks gorulmedi. Hastalarin ortalama takip suresi 29.8 ay olup, ortanca takip suresi 16 (2-80) ay olarak tespit edildi. 12 hastanin 10a#39;u yasamakta olup 2a#39;si exitus oldu. Sonuc: Uygun hastalarda multidisipliner calisma ile neoadjuvan kemoterapi sonrasi lokal ileri evre meme kanserlerinde meme koruyucu cerrahi ve sentinel lenf nodu yapilabilinir ve erken evre meme kanserinde oldugu gibi kur sansi saglanabilir.