Breast Conserving Therapy (BCT)

ที่ Ochsner Clinic25 ได้ศึกษาผู้ป่วย LABC ซึ่งได้รับการรักษานำด้วยเคมีบำบัด แล้วทำ mastectomy ทั้งนี้เพื่อศึกษาว่า ผู้ป่วยในกลุ่มนี้สามารถที่จะรักษาด้วย BCT ได้หรือไม่ พบว่า ในผู้ป่วยที่มะเร็งปฐมภูมิลุกลามไปยังผิวหนัง (T4) หรือ มีการลุกลามไปต่อมน้ำเหลือง N2 N3 ผู้ป่วยกลุ่มนี้จะมีโอกาสที่จะรับการรักษาด้วย BCT ได้น้อยมาก แต่ในผู้ป่วย T3 N0 หรือ T3 N1 นั้น 60% สามารถรับการรักษาด้วย BCT หลังได้เคมีบำบัดแล้ว รายงานจาก Instituto Nazionale Tumori ใน Milan ประเทศ Italy พบว่า การให้เคมีบำบัดก่อนผ่าตัดสามารถลดขนาดของมะเร็งปฐมภูมิให้เล็กกว่า 3 ซม. จากเดิม 3-4 ซม. ใน 98% ของผู้ป่วย จาก 4.1-5 ซม. ใน 80% ของผู้ป่วย26 จาก 5.1-6 ซม. ใน 79% ของผู้ป่วย และจากโต กว่า 6 ซม. ใน 27% ของผู้ป่วย 27, 28 ผลการศึกษาจาก randomized trials ต่าง ๆ พบว่า การรักษาวิธีนี้ได้ผลไม่แตกต่างจากการให้เคมีบำบัดหลังผ่าตัด29, 30, 31, 32, 33, 34

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