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.

Background: breast cancer is the most frequent diagnosed visceral cancer with 13400 new cases annually among Iranian women. Modified radical mastectomy (MRM) was the old standard surgical treatment in patients with breast cancer from 70 years ago and breast-conserving surgery (BCS) with adjuvant radiotherapy was the standard treatment from 30 years ago. Objectives: In this matched historical cohort study, we compared two types of therapy for breast carcinoma: breast-conserving therapy (BCT), and MRM. Methods: Medical records of 6000 patients with breast cancer from the database of Cancer Research Center of Shahid Beheshti University of Medical Sciences were reviewed and 1310 patients who had been treated by BCT (group A) or MRM (group B) were selected based on a time-stratified 1: 1 between September 2002 and December 2014 as 10 baseline variables. By log-rank test analysis, their local recurrence (LR), disease free survival (DFS) and overall survival (OS) were evaluated and compared. Results: In groups A and B, the median age at the diagnosis time was 48. 11 and 48. 64 years old, respectively. Median follow-up time was 71 months since April 2015. 1. 68% of patients in group A and 1. 07% of patients in group B had local recurrence during the five years of follow up, (P = 0. 173). In the group A and B, five years DFS were 87. 94% and 80. 46%, (P < 0. 001) and five years OS were 89. 31% and 83. 02%, respectively (P = 0. 041). Conclusions: The findings of this study showed that 5-year DFS and 5-year OS in BCT group were better than in the MRM group. Longer follow-up time of the patients tocompare10-year DFSand10-yearOSor even 20-yearOSbetweentwogroups isrecommended.