有人提出 NAC 后保乳手术 (BCS) 局部复发风险增加的问题，凸显了该患者群体中最佳切缘宽度的不确定性。我们研究了 NAC 之后接受 BCS 的患者切缘状态与局部无复发生存 (LRFS) 之间的关联。我们对 2012 年至 2012 年期间接受 NAC 后接受 BCS 的 I-III 期乳腺癌成年女性患者进行了回顾性队列研究。 2021 年在两个癌症中心。如果切缘 < 1 毫米，则被归类为“接近”。完整队列包括 544 名患者，中位年龄为 53 岁（四分位距 [IQR] 44-64）。整个队列中 41.2% 的人实现了病理完全缓解 (pCR) (n = 224)。在 320 例有残留病灶的患者中，29.4% (n = 94) 具有至少 1 个闭合边缘，10.9% (n = 35) 具有 ≥2 个闭合边缘。中位随访时间为 55 个月（IQR 32-83）； 4.8% 的患者出现同侧乳房复发 (n = 26)。 pCR 患者的 5 年 LRFS 高于残留病患者（98.0% vs. 91.6%，p = 0.02）。对于有残留病灶的患者，不同切缘类别（清晰 vs. 1 个闭合切缘 vs. ≥2 个闭合切缘）的 5 年 LRFS 没有差异（92.2% vs. 88.9% vs. 92.9%）（p = 0.78）。在 NAC 后接受 BCS 的患者中，与手术时有残留病灶的患者相比，实现 pCR 的患者的 LRFS 显着较高，但 LRFS 与切缘宽度或紧密切缘数量无关。© 2024。Society of Surgical肿瘤学。

Questions have been raised as to an increased risk of local recurrence with breast-conserving surgery (BCS) post NAC highlighting the uncertainty around optimal margin width in this patient population. We examined the association between margin status and local recurrence-free survival (LRFS) in patients who underwent BCS following NAC.We performed a retrospective cohort study of adult female patients with stage I-III breast cancer who underwent NAC followed by BCS between 2012 and 2021 at two cancer centers. Margins were categorized as "close" if they were < 1 mm.The full cohort included 544 patients with a median age of 53 years (interquartile range [IQR] 44-64). Pathologic complete response (pCR) was achieved in 41.2% of the overall cohort (n = 224). Of the 320 with residual disease, 29.4% (n = 94) had at least one close margin, and 10.9% (n = 35) had ≥2 close margins. Median follow-up was 55 months (IQR 32-83); 4.8% had an ipsilateral breast recurrence (n = 26). Patients with pCR had a higher 5-year LRFS than those with residual disease (98.0% vs. 91.6%, p = 0.02). There was no difference in 5-year LRFS between the margin categories (clear vs. 1 close margin vs. ≥2 close margins) in those with residual disease (92.2% vs. 88.9% vs. 92.9%) (p = 0.78).In patients undergoing BCS post-NAC, those who achieved pCR had a significantly higher LRFS compared with those with residual disease at the time of surgery, but LRFS was not associated with margin width nor the number of close margins.© 2024. Society of Surgical Oncology.