الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Multimodality therapy is the standard of care with neo-adjuvant systemic therapy for all women with locally advanced breast cancer with the advantage to induce tumor response, enable in vivo evaluation of its efficacy, improve surgical options because of the tumor response to therapy, facilitate local control through subsequent surgery and radiation therapy and improve overall survival.
Breast conservation surgery is a definitive feasible and safe option as long as a clear margin is obtained and postoperative radiotherapy is completed.
This study was conducted on 50 female patients diagnosed with locally advanced breast cancer and received neo-adjuvant chemotherapy at El Menoufia University Hospital and Tanta Cancer Center from March 2017 to March 2018 with our aim to assess feasibility of conservative breast surgery and the oncologic outcome.
Preoperatively, all the studied cases were subjected to full clinical history, general examination, breast & axilla examination, routine laboratory investigations, breast mammography with complementary ultrasound, tru-cut needle biopsy, metastatic workup and informed consent was collected from all patients before participation in the study.
Conservative breast surgery with intraoperative frozen section was performed in all cases and free margin was assured in all of them. Postoperatively, all of our cases were thoroughly followed up after 3, 6 and 12 months except for the one female who missed the follow up. No local recurrence was noted in any case. Seroma was the most frequent complication in our study with a percentage of 22% followed by wound infection that occurred in 8% of our cases.
The followed up cases were evaluated for cosmetic outcome by Harvard scale, excellent outcome resulted in 86%, Good outcome was found in 8% of the patients and 6% with fair outcome.
All of the followed up cases were asked to rate their degree of satisfaction, 54% patients rated excellent satisfaction, 32% rated good satisfaction with only 10% stated fair satisfaction and 4% stated poor score.
Patients of locally advanced breast cancer who were included in our study and underwent treatment with neoadjuvant chemotherapy had shown excellent response through downgrading the tumor size, axillary lymph nodes and pathological response. So, we may conclude here that the conventional neoadjuvant chemotherapy is effective in our study.
Breast conservation after neoadjuvant chemotherapy is safe in terms of surgical and esthetic outcome in women with locally advanced breast cancer during the limited follow up time of this study.
We recommend performing further studies with larger population scale and longer follow-up to confirm and support the results.