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The impact of atypical hyperplasia at the margins of breast-conserving surgery on the outcomes of breast cancer in patients treated with neoadjuvant chemotherapy

Purpose Women with atypical hyperplasia (AH) is associated with a higher
risk of later breast cancer. However, whether AH found at margins in
patients with breast-conserving surgery (BCS) and neoadjuvant
chemotherapy (NAC) needs re-excision is not well-defined. The aim of the
present study was to evaluate the impact of atypical hyperplasia at the
surgical margins on the local recurrence and survival outcomes in breast
cancer patients treated with NAC and BCS. Methods A retrospective
analysis comparing patients who received NAC with AH and received no
re-excision to those without AH at the margins of BCS was performed.
Results 323 patients were included in this study. The 5-year rates of
ipsilateral breast tumor recurrence (IBTR) were 6% and 4.5% in
patients with and without AH, respectively. Distant-metastasis-free
survival (DMFS) at 5 years was 81.2% in the AH group, and 88.1% in the
no-AH group. No significant differences were observed among the two
groups in terms of IBTR, DMFS, or OS. Conclusion Our study suggests that
AH involved at the surgical margins of BCS in patients who received NAC
does not increase the risk of ipsilateral breast cancer, and there is
insufficient evidence for surgeon to further resect AH found at the
margins of BCS in these patients.