[The application of conservative surgery for local advanced and bigger primary breast carcinoma].

Objective: To discuss the application of conservative surgery for local advanced and bigger primary breast carcinoma (> 4 cm in diameter).

Methods: Thirty-three primary breast cancer patients with tumor diameter more than four centimeters were treated with wide local excision and axillary lymph node dissection. Before operation, neoadjuvant chemotherapy with anthracyclines based combined regimen was done in thirty-one patients.

Results: Thirty-one patients received one to eight cycles of neoadjuvant chemotherapy (mean 3.7 cycles). The response rate was 100%, including clinical complete remission in 19 cases, clinical partial remission in 12 cases and pathological complete remission in 9 cases. The final margin negative rate was 100% in thirty-three patients and first margin negative rate was 75.8% during operation. After a median follow-up of 27 months (range 2-39 months), up to date yet, no relapse case was found. The relapse-free survival was 100%.

Conclusions: Combining with neoadjuvant chemotherapy, breast-conserving therapy can be done successfully for most primary breast cancer patients with local advanced and bigger tumor. The curative effect was the same as the patient with smaller tumor in a short term follow-up.