الفهرس 
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Abstract
This study conducted to evaluate the feasibility of breast conserving therapy in patient with large breast tumors after application of preoperative neoadjuvant chemotherapy. The study performed in the surgical oncology unite in Alexandria main university hospital. 58 female patients with large breast tumor shared in the study after application of informed consent, they evaluated clinically, radiologically and true cut needle biopsy from the mass with administration of metal clip in the tumor to facilitate complete excision of the mass with accepted safety margins.
Histopathological examination and immunohistochemistry was done to stratify the patients into biological subtypes, luminal A and B, Her2 positive or negative and Triple negative patients. Full laboratory investigations and radiological examinations of the breast, abdomen and chest, to exclude cases with metastatic tumor. The study includes patients with stage II and IIIA.
All patients with skin or muscle infiltrations, or distant metastasis and patients with contra-indication to radiotherapy excluded from the study. All the patients received preoperative systemic chemotherapy for 6 cycles, the regimen composed of 2 or more chemical substances to avoid resistance to chemotherapy. the patients evaluated after 3 cycles and according to their response to be candidate for breast conservation or not according to the mass size after chemotherapy (4 cm or less is candidate to BCS, more than 5 cm not candidate).breast conservation were illegible in about 65% of our patients. Surgery was performed 3 to 4 weeks after cessation of neoadjuvant chemotherapy.