ArticleAnnals of surgical oncology2026
Breast-Conserving Therapy for Multiple Ipsilateral Breast Cancer After Neoadjuvant Systemic Therapy.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundThe ACOSOG Z11102 trial demonstrated the safety of breast-conserving surgery (BCS) with adjuvant radiation in women with multiple ipsilateral breast cancer (MIBC) undergoing upfront surgery, reporting a 5-year local recurrence (LR) of ~3%. However, the oncologic safety of BCS in women with MIBC receiving neoadjuvant systemic therapy (NST) remains uncertain. PATIENTS AND
methodsPatients with stage I-III unifocal or MIBC who underwent BCS following NST from 2016 to 2023 were identified in a prospectively maintained institutional database. MIBC was defined preoperatively as the presence of 2-3 foci of biopsy-proven breast cancer with at least 2 cm of intervening normal breast tissue and at least one focus of invasive disease.
resultsA total of 1515 patients were identified: 73 (4.8%) with MIBC and 1442 (95.2%) with unifocal disease. Baseline clinicopathologic characteristics were similar between groups. Median age was 55 years, and most received neoadjuvant chemotherapy (82.2% vs. 83.4%). Molecular subtype distribution was similar between cohorts (p = 0.97). Of the patients with MIBC, 48 (65.8%) underwent single-site lumpectomy, 23 (31.5%) two-site lumpectomy, and 2 (2.7%) three-site lumpectomy. At median follow-up of 34.7 months, there was no difference in LR (1.4% vs. 3.1%, p = 0.40), distant recurrence (5.5% vs. 4.6%, p = 0.37), or breast cancer mortality (4.1% vs. 2.6%, p = 0.45) between groups.
conclusionsIn this retrospective analysis of women with MIBC who underwent BCS after NST, local recurrence (LR) was 1.4% at 3-year median follow-up, which was similar to patients with unifocal breast cancer. These findings suggest BCS is a safe surgical option in well-selected patients with MIBC undergoing NST.
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