Role of neo‑adjuvant chemotherapy in locally advanced breast cancer.
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Date
2015-07
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Abstract
BACKGROUND AND AIMS: Locally advanced breast cancer (LABC) is common in developing countries. The advancement of disease leads to
decreased probability of radical cure and increase in treatment cost. The study evaluated neo adjuvant chemotherapy with MRM and MRM
followed by adjuvant chemotherapy and also the effectiveness of neo‑adjuvant chemotherapy in down staging advanced disease and offering
radical cure. SETTINGS AND DESIGN: A rural hospital‑based prospective comparative study. MATERIALS AND METHODS: All histologically proven
and investigated LABC (T3 N0, T3N1, Any T4, Any N2/N3, M0) were selected as subjects and divided into two groups. One group received neo
adjuvant chemotherapy (5 fluorouracil, adriamycin and cyclophosphamide) followed by modified radical mastectomy and other group received
adjuvant chemotherapy after modified radical mastectomy. Both groups were compared for disease free survival, overall survival and post‑operative
complications. Tumor response to chemotherapy in neo adjuvant group was also studied. STATISTICAL ANALYSIS: All continuous variables were
analyzed using student’s’ test and categorical variable by Fischer exact test. RESULTS: Thirty one patients were enrolled, of these 16 patients
received neo adjuvant chemotherapy. Clinical complete response was observed in two patients (12.5%). Clinical partial response was found in
12 patients (75%) and no response was seen in two patients (12.5%). Disease free survival and overall survival was 82% in neo adjuvant group
while in adjuvant group disease free survival was 75% and overall survival was 83%. Post operative complications were similar in both groups.
CONCLUSION: Neo adjuvant chemotherapy helps in down staging LABC and offers opportunity in vivo to assess the effect of chemotherapy on
individual basis. There was no significant difference in disease free survival, overall survival and post operative complication in between two groups.
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Breast cancer, locally advanced breast cancer, neo adjuvant chemotherapy, adjuvant chemotherapy
Citation
Akhtar M, Akulwar V, Kulkarni A, Bansal A. Role of neo‑adjuvant chemotherapy in locally advanced breast cancer. Indian Journal of Cancer. 2015 July-Sept; 52(3): 286-289.