{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:34:44Z","timestamp":1791434084230,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2018,5,3]],"date-time":"2018-05-03T00:00:00Z","timestamp":1525305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,7,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Several studies have reported a high risk of local disease recurrence (LR) and locoregional disease recurrence (LRR) in patients with breast cancer after neoadjuvant chemotherapy (NCT) and breast\u2010conserving therapy (BCT). The objective of the current study was to identify potential risk factors for LR and LRR after NCT and BCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Individual patient data sets from 9 studies were pooled. The outcomes of interest were the occurrence of LR and\/or LRR. A 1\u2010stage meta\u2010analytic approach was used. Cox proportional hazards regression models were applied to identify factors that were predictive of LR and LRR, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 9 studies (4125 patients) provided their data sets. The 10\u2010year LR rate was 6.5%, whereas the 10\u2010year LRR rate was 10.3%. Four factors were found to be associated with a higher risk of LR: 1) estrogen receptor\u2010negative disease; 2) cN\u2009+\u2009disease; 3) a lack of pathologic complete response in axilla (pN0); and 4) pN2 to pN3 disease. The predictive score for LR determined 3 risk groups: a low\u2010risk, intermediate\u2010risk, and high\u2010risk group with 10\u2010year LR rates of 4.0%, 7.9%, and 20.4%, respectively. Two additional factors were found to be associated with an increased risk of LRR: cT3 to cT4 disease and a lack of pathologic complete response in the breast. The predictive score for LRR determined 3 risk groups; a low\u2010risk, intermediate\u2010risk, and high\u2010risk group with 10\u2010year LRR rates of 3.2%, 10.1%, and 24.1%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>BCT after NCT appears to be an oncologically safe procedure for a large percentage of patients with breast cancer. Two easy\u2010to\u2010use clinical scores were developed that can help clinicians to identify patients at higher risk of LR and LRR after NCT and BCT and individualize the postoperative treatment plan and follow\u2010up. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:2923\u201030.<\/jats:bold> \u00a9 <jats:italic>2018 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31518","type":"journal-article","created":{"date-parts":[[2018,5,3]],"date-time":"2018-05-03T19:05:23Z","timestamp":1525374323000},"page":"2923-2930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Risk factors for locoregional disease recurrence after breast\u2010conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: An international collaboration and individual patient meta\u2010analysis"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-0194","authenticated-orcid":false,"given":"Antonios","family":"Valachis","sequence":"first","affiliation":[{"name":"Centre for Clinical Research Sormland Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftherios P.","family":"Mamounas","sequence":"additional","affiliation":[{"name":"Comprehensive Breast Program University of Florida Health Cancer Center\u2010Orlando Health Orlando Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Mittendorf","sequence":"additional","affiliation":[{"name":"Department of Breast Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-4603","authenticated-orcid":false,"given":"Naoki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery St. Luke's International Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ishitobi","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Osaka International Cancer Institute Osaka Japan"},{"name":"Department of Endocrine Surgery Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Natoli","sequence":"additional","affiliation":[{"name":"Department of Oral, Medical and Biotechnological Sciences University G. D'Annunzio Chieti\u2010Pescara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Fitzal","sequence":"additional","affiliation":[{"name":"Department of Surgery, Breast Health Center Medical University Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel T.","family":"Rubio","sequence":"additional","affiliation":[{"name":"Breast Surgical Oncology, Breast Cancer Center University Hospital VAll d'Hebron Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Tiezzi","sequence":"additional","affiliation":[{"name":"Breast Disease Division, Department of Gynecology and Obstetrics, Ribeirao Preto Medical School University of Sao Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee\u2010Chul","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Surgery Chung\u2010Ang University Hospital Seoul South 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