Outcome of Wire localized Lumpectomies in Breast Cancer Following Neoadjuvant Chemotherapy
Objective: To evaluate the clinical outcome of our breast cancer patients who had non-palpable lesions following neoadjuvant chemotherapy and required wire localized lump excision. Apart from survival outcome; specimen size was calculated and results compared to published literature. Study Design: A retrospective analysis. Place and Duration: Shaukat Khanum Memorial Cancer Hospital, Lahore from August 2005 to December 2011. Methodology: A retrospective analysis of consecutive series of patients treated at Shaukat Khanum Memorial Cancer Hospital with breast conservation after wire localization for non-palpable breast cancer following neoadjuvant chemotherapy. The records were reviewed for patient, radiological, histological and surgical characteristics. Tumor volume was calculated from the pathological specimen size. Data was analyzed using SPSS Version 19.0. Kaplan-Meier curves were used for survival analysis. Results: A total of 194 were included in the study. The mean age was 44yrs (Range 22-78yrs). Complete pathological response was seen in 65 patients. After the first excision 90.2% of the patients had negative margins. Seventeen patients underwent re-operation of which 7 had re-excision alone and 8 required completion mastectomy. The mean resected specimen volume was 634.72 cm3. Loco-regional recurrence occurred in 13 (6.7%) cases and distant recurrence was seen in 36 (18.6%) cases. Out of these, 6 patients had both local and distal recurrence. The median survival was 44 months (SD 17.16). Conclusion: Our patients present at advanced stages which makes neo-adjuvant chemotherapy an integral part of their management. Wire guided localization of non-palpable tumors following downsizing is an effective and feasible technique with good surgical outcome.