A prospective single arm cohort study: An analysis of the effectiveness of surgical treatment of locally advanced breast cancer

TL;DR

This study shows that surgery followed by adjuvant therapy can improve survival and quality of life for patients with locally advanced breast cancer.

Contribution

The study demonstrates the effectiveness of surgical treatment for locally advanced breast cancer with skin invasion.

Findings

Patients had 1-year, 3-year, and 5-year disease-free survival rates of 69.8%, 53.3%, and 37.5%.

Overall survival rates were 100.0%, 85.6%, and 68.0% at 1, 3, and 5 years.

Patients showed improved functional status and quality of life after surgery.

Abstract

Breast cancer stands as a globally significant contributor to both incidence rates and mortality among women. Approximately 10–15 % of women will face a diagnosis of an advanced yet potentially treatable stage of the disease. When individuals diagnosed with locally advanced breast cancer (LABC) exhibit resistance to preoperative chemotherapy and experience tumor progression, they unfortunately forfeit the opportunity for surgical intervention, thereby diminishing the prospects for a radical cure.

We conducted a prospective, single-arm cohort study aimed at evaluating the feasibility of locally modified radical resection for LABC with skin invasion. The primary endpoints encompassed overall survival (OS) and disease-free survival (DFS), whereas the secondary endpoint focused on the quality of life (QoL) among breast cancer patients.

Between March 2018 and December 2022, a total of 38 eligible patients were enrolled in this study. The Kaplan-Meier estimates for 1-year, 3-year, and 5-year DFS among all patients were 69.8 %, 53.3 %, and 37.5 %, respectively. Correspondingly, the OS rates were 100.0 %, 85.6 %, and 68.0 %. Both univariate and multivariate analyses revealed that patients with a history of neoadjuvant chemotherapy who exhibited stable or progressive disease had inferior DFS outcomes. Notably, patients demonstrated clinically meaningful and statistically significant enhancements in functional status and overall QoL. However, no notable improvement was observed in specific symptom domains.

Patients with locally advanced breast cancer, specifically those presenting with T4 tumors, who undergo surgical intervention followed by postoperative adjuvant therapy, can attain favorable prognostic outcomes and experience an enhanced quality of life.

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