Outcome if Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer: A Tertiary Care 11 Center Experience

Journal of Surgical Sciences Pub Date : 2019-11-05 DOI:10.3329/jss.v20i1.43796

S. Rahman, P. Akhter, N. Khatun, Hasanuzzaman, M. Rahman, Nabir Hossen, A. U. Haque, A. Bhattacharjee

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Abstract

Background: Breast cancer is the most common cancer of Bangladeshi women. Almost allpresent with palpable lump and 40% of them are with locally advanced breast cancer.Neoadjuvant chemotherapy is the standard choice of treatment for the patients. Objective: To observe the clinical and pathological response of locally advanced breastcancer after four cycles of chemotherapy and surgery. Methods: This prospective study was carred over the newly diagnosed locally advancedbreast cancer (LABC) patients from January 2010 to December 2014. Before going toneoadjuvant chemotherapy each patient was evaluated clinically, radiologically and withother relevant investigations. The size of primary tumor and axillary node was measured andrecorded. Chemotherapy schedule with Cyclophosphamide 600mg/m2 and Doxorubicin60mg/m2 (AC) and compared with the previous record. After 3-4 weeks of completion ofchemotherapy, the patients was prescribed and carried out three weekly for four cycles.Primary tumor size and axillary nodal size was measured who were undergone mastectomyand axillary dissection. Histopathology was done to see then the pathological response ofprimary tumor and axillary node. Other biological marker such as estrogen receptor (ER),progesterone receptor (PR) and Human epidermal growth receptor (HER-2) was done. Aftercompletion of study the data was compiled and analyzed. Results: Total 220 cases of LABC were enrolled in this study. After four cycles of chemotherapywith AC, 194 patients (88%) responded clinically, 29 patients (13%) showedcomplete clinical response (cCr)-and 165 patients (75%) partial response (pCr). Surgicalspecimen showed complete pathological response (cPr) in 22 patients (10%). Conclusion: Neoadjuvant chemotherapy with AC is the standard chemotherapy schedule forlocally advanced breast cancer and radical surgery was possible in 75% of the patients. Journal of Surgical Sciences (2016) Vol. 20 (1) : 13-17

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局部晚期乳腺癌新辅助化疗的结果:三级护理中心的经验

背景:乳腺癌是孟加拉国妇女最常见的癌症。几乎所有患者都有可触及的肿块，其中40%为局部晚期乳腺癌。新辅助化疗是患者治疗的标准选择。目的:观察局部晚期乳腺癌经4个周期化疗和手术治疗后的临床和病理反应。方法:对2010年1月至2014年12月新诊断的局部晚期乳腺癌(LABC)患者进行前瞻性研究。在进行辅助化疗之前，每位患者都进行了临床、放射学和其他相关检查。测量并记录原发肿瘤及腋窝淋巴结的大小。化疗方案:环磷酰胺600mg/m2 +阿霉素60mg/m2 (AC)，并与既往记录比较。化疗完成3-4周后，患者按规定每周进行3次化疗，共4个周期。对行乳房切除术和腋窝清扫的患者进行原发肿瘤大小和腋窝淋巴结大小的测量。通过组织病理学观察原发肿瘤和腋窝淋巴结的病理反应。其他生物标志物如雌激素受体(ER)、孕激素受体(PR)和人表皮生长受体(HER-2)。研究完成后，对数据进行整理和分析。结果:本研究共纳入LABC 220例。在4个化疗周期后，194例(88%)患者有临床反应，29例(13%)患者有完全临床反应(cCr)， 165例(75%)患者有部分反应(pCr)。手术标本显示完全病理反应(cPr) 22例(10%)。结论:AC新辅助化疗是局部晚期乳腺癌的标准化疗方案，75%的患者可进行根治性手术。外科杂志(2016)Vol. 20 (1): 13-17

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Journal of Surgical Sciences

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审稿时长

6 weeks