feasibility of breast conserving surgery in stage iiia breast carcinoma patients in the absence of neoadjuvant therapy

background: preoperative determination of the extent of viable residual tumor is an important issue after neoadjuvant treatment. on the other hand, retrospective data suggest that breast-conserving surgery is feasible up to stage iiia breast cancer without preoperative therapy. methods: we retrospectively analyzed 164 patients who underwent breastconserving surgery followed by adjuvant chemotherapy and/or endocrinal therapy with whole breast radiation between 2005 and 2012. of those, 116 patients had stages i and ii (group 1) breast cancer, whereas 48 patients had stage iiia (group 2). results: after a median follow-up of 40.4 months, 18 (15.5%) patients in group- 1and 8 (16.6%) in group-2 developed ipsilateral breast tumor recurrence (p=0.77). mean time to tumor recurrence was 19 months in group 1 and 17 months in group 2 (p=0.5). however we found more ipsilateral breast tumor recurrence in hormone negative tumors (p=0.002), high grade tumors (p=0.021), young age (p=0.017) and lymph node positive cases (p=0.011). we observed no significant difference between n1 and n2 lymph node status (p=0.241). conclusion: our data suggest that breast-conserving surgery with r0 resection is feasible in stage iiia cases whenever cosmetic appearance can be maintained as long as surgery will be followed by radiotherapy and chemotherapy. a prospective study with larger numbers is recommended for further evaluation of this issue.