尽管新辅助化疗（NAC）已被证明能提高乳腺癌保乳手术（BCS）的率，但浸润性小叶癌（ILC）的治疗反应率似乎低于其他组织学亚型。一些数据显示，绝经前比绝经后患者对NAC的治疗反应率更高，但这在ILC中并未进行研究。我们评估了按绝经状态分层的ILC患者接受NAC后成功进行BCS的比率。我们分析了一家单独机构的666名患有I-III期激素受体阳性HER-2阴性ILC的患者的数据。我们使用t检验、卡方检验和多变量 logistic 回归分析了NAC使用率、尝试BCS率以及NAC与成功BCS之间的关联和绝经状态。在217名绝经前和449名绝经后的患者中，绝经前组更常使用NAC（分别为15.2%与9.8%，p = 0.041）。在尝试乳腺保留手术的患者中（分别为绝经前组的51.3%和绝经后组的64.8%），NAC与任何一组中的成功BCS无关。有趣的是，对于绝经后的患者来说，在第一次尝试BCS时，NAC的接受与那些存在阳性切缘的患者完成乳房切除术的比率显著相关。无论是绝经前还是绝经后的ILC患者，NAC与成功BCS无关。尽管绝经前患者更有可能接受NAC，但这些数据表明绝经状态可能不是预测化疗反应的良好指标。需要更好的化疗反应预测指标和更有效的ILC治疗方法。© 2023. 作者（们）。

While neoadjuvant chemotherapy (NAC) has been shown to increase rates of breast conservation surgery (BCS) for breast cancer, response rates in invasive lobular carcinoma (ILC) appear lower than other histologic subtypes. Some data suggest higher response rates to NAC in premenopausal versus postmenopausal patients, but this has not been studied in ILC. We evaluated the rates of successful BCS after NAC in patients with ILC stratified by menopausal status.We analyzed data from a single-institution cohort of 666 patients with stage I-III hormone receptor positive HER-2 negative ILC. We used t-tests, chi-squared tests, and multivariable logistic regression to investigate rates of NAC use, attempted BCS, and associations between NAC and successful BCS by menopausal status.In 217 premenopausal and 449 postmenopausal patients, NAC was used more often in the premenopausal group (15.2% vs. 9.8%, respectively, p = 0.041). Among those who attempted breast conservation (51.3% of pre- and 64.8% of postmenopausal cohorts), NAC was not associated with successful BCS in either group. Interestingly, for postmenopausal patients, receipt of NAC was significantly associated with increased rates of completion mastectomy in those who had positive margins at the first attempt at BCS.NAC was not associated with successful BCS in either premenopausal or postmenopausal patients with ILC. Although premenopausal patients were more likely to receive NAC, these data suggest that menopausal status may not be a good predictor of response to chemotherapy. Better predictors of response and more efficacious treatment for patients with ILC are needed.© 2023. The Author(s).