IMPACT OF NEOADJUVANT CHEMOTHERAPY ON LOCALLY ADVANCED BREAST CANCER
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 69
Abstract
BACKGROUND Locally advanced breast cancer (LABC) is a common presentation in India with patients presenting with large breast masses with skin involvement or matted axillary nodes, which constitutes 40% of the clinical presentation in medical institutions. The advent of neoadjuvant chemotherapy has radically changed the management of locally advanced breast cancer and a complete response is reported to significantly improve disease free survival. In this study, an attempt was made to check impact of NACT on LABC downstaging as well as assessment of association of clinical response in ER/PR positive LABC cases. Study Design- Case series of 50 locally advanced breast cancer cases. MATERIALS AND METHODS Fifty patients with locally advanced breast cancer, who were admitted in GMCH were selected for the study. True-cut biopsies were performed on all the cases to obtain hormonal receptor status and histology. All patients were put on 4AC-4T (Adriamycin, cyclophosphamide, taxen) NACT regime, at the end of 8th cycle tumour status were evaluated. Post-operative pathological staging obtained were compared with pre-NACT clinical staging. Statistical analysis were done using SPSS version 16.0. An association was found between clinical complete response and hormone receptor positive breast cancer with ‘p’ value of 0.0013 (p < .05). RESULTS All the LABC cases studied in this series were in stage IIIA (72%) and stage IIIB (28%). Majority of cases 26 (52%) showed ER-/PRreceptor status and 10 (20%) cases showed ER+/PR+ receptor status. In the present series seven cases (14%) showed complete response, 26 (52%) cases showed partial response and 17 (34%) cases showed no response. All the cases showed downstaging with two complete pathological response. Out of 36 stage IIIA, 16 cases fell to stage IIB, 18 cases fell to stage IIA and 2 dropped to zero and out of 14 stage IIIB, 8 cases fell to stage IIIA, 5 cases fell to stage IIB and 1 case dropped to stage IIA following NACT. CONCLUSION Hormone receptor positive LABC cases responding well to the NACT and a poor response was noticed in stage IIIB disease.
Authors and Affiliations
Surajit Hazarika, Deka R. K, Kumar P. C
Keywords
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- EP ID EP233253
- DOI 10.14260/Jemds/2017/1076
- Views 73
- Downloads 0
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