DOI: http://dx.doi.org/10.18203/2349-2902.isj20195398

A clinical study of outcome of neoadjuvant chemotherapy in 30 cases of locally advanced breast carcinoma

Shwetal Ravindrabhai Sonvane, Mukesh Pancholi, Akhil Sharma

Abstract


Background: Locally advanced breast cancer presents with a difficult management problem. It remains a challenge to achieve local and distant control of locally advanced breast cancer. Over the last decade preoperative/ neoadjuvant chemotherapy has emerged as the standard of care for these patients. Successful reduction in the size of the tumor is associated with increased rate of operability. The objective of this study is to observe the response of neoadjuvant chemotherapy in locally advanced breast carcinoma in form of outcome and complications. The outcome is measured as down staging or downgrading of tumor, results of surgery and its complications, disease free survival and recurrence.

Methods: This is the observational prospective study of consecutive 30 cases of locally advanced breast cancer admitted in department of general surgery during a period from May 2017 to August 2018 at new civil hospital, Surat. Neo adjuvant chemotherapy were given every three weekly and the response of therapy calculated in form of reduction in the size of tumor or getting the margin free from skin or pectoral muscles or reduction in the axillary lymph node mass.

Results: In this study about 93% of cases responded to neoadjuvant chemotherapy with 10% of cases shows complete clinical response where tumor becomes completely free from skin or pectoral muscles or negative axillary lymph nodes.

Conclusions: With the evidence from the literature and study conducted earlier, our observations of clinical response of neoadjuvant chemotherapy in patients with locally advanced breast cancer had corroborative evidence.


Keywords


Locally advanced breast cancer, Neoadjuvant chemotherapy, Breast conserving surgery

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References


Valero VV, Buzdar AU, Hortobagyi GN. Locally Advanced Breast Cancer. Oncologist. 1996;1:8-17.

Mougalian SS, Soulos PR, Killelea BK, Lannin DR, Abu-Khalaf MM, DiGiovanna MP, et al. Use of neoadjuvant chemotherapy for patients with stage I to III breast cancer in the United States. Cancer. 2015;121(15):2544-52.

Arimappamagan A, Kadambari D, Srinivasan K, Krishnan R, Elangovan S, Reddy KSN. Complete axillary conversion after neoadjuvant chemotherapy in locally advanced breast cancer: a step towards conserving axilla?. Indian J Cancer. 2004;1(41):13-7.

Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. N Eng J Med. 1995;14:901-6.

K├╝mmel S, Krocker J, Kohls A, Breitbach GP, Morack G, Budner M, et al. Randomised trial: survival benefit and safety of adjuvant dose-dense chemotherapy for node-positive breast cancer. Br J Cancer. 2006;94:1237-44.

Kuerer HM, Newman LA, Smith TL, Ames FC, Hunt KK, Dhingra K, et al. Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol. 1999;17:460-9.

Singletary SE, McNeese MD, Hortobagyi GN. Feasibility of breast-conservation surgery after induction chemotherapy for locally advanced breast carcinoma. Cancer. 1992;69:2849-52.

Hortobagyi GN, Ames FC, Buzdar AU, Kau SW, McNeese MD, Paulus D, et al. Management of stage III primary breast cancer with primary chemotherapy, surgery, and radiation therapy. Cancer. 1988;62:2507-16.

VanderHage JA, van de Velde CJ, Julien JP, Tubiana-Hulin M, Vandervelden C, Duchateau L. Preoperative chemotherapy in primary operable breast cancer: Results from the European organization for research and treatment of cancer trial 10902. J Clin Oncol. 2001;19:4224-37.

Raina V, Kunjahari M, Shukla NK, Deo SV, Sharma A, Mohanti BK, et al. Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in Northern India. Indian J Cancer. 2011;48:80-5.