Experience with neoadjuvant chemotherapy in patients with breast cancer

• Published in: Journal of the Pakistan Medical Association Vol. 60; no. 4; pp. 284 - 287
• Main Authors: KHAWAJA FARHAN ZAHID, MUHAMMAD KAMRAN SIDDIQUE, SIDDIQUI, Neelam, MUZAFFAR, Narjis, ASIM, Muhammad, AZFAR, Muhammad
• Format: Journal Article
• Language: English
• Published: Karachi Pakistan Medical Association 01.04.2010
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Breast Neoplasms - drug therapy; Breast Neoplasms - surgery; Chemotherapy, Adjuvant; Chi-Square Distribution; Disease Progression; Female; General aspects; Gynecology. Andrology. Obstetrics; Humans; Logistic Models; Lymphatic Metastasis; Mammary gland diseases; Medical sciences; Middle Aged; Neoadjuvant Therapy; Neoplasm Invasiveness; Retrospective Studies; Treatment Outcome; Tumors; Human; Mammary gland diseases; Chemotherapy; Breast disease; Treatment; Tropical medicine; Breast cancer; Malignant tumor; Neoadjuvant treatment; Cancer
• ISSN: 0030-9982

To determine the response rates to neoadjuvant chemotherapy in patients with breast cancer. Medical records of 161 women with breast cancer, registered at Shaukat Khanum Memorial Cancer Hospital between July 2006 and March 2008 were retrospectively reviewed. Patients were stratified into two groups based on the type of chemotherapy received; Group A (Anthracycline based regimens), Group B (Anthracycline and Taxane based regimens). Response rate was noted. Clinical complete response rates by clinical examination were significantly higher in Group B as compared to Group A in both primary disease in breast and axillary nodes (39% vs. 20.3%, p = 0.01; 72.7% vs. 30.7%, p = 0.01, respectively). There was no difference in response rates by imaging between groups A and B in breast and axillary lymph nodes (12.5% vs. 17%, p = 0.4; 66.6% vs. 70.4%, p = 0.4, respectively). There was no difference in pCR rates between Group A and B (9.1% vs. 14.2%, p = 0.35). However, multivariate analysis showed significant increase in pCR rates by addition of taxanes (p = 0.028), in patients with poorly differentiated tumours (p = 0.028) and in those with axillary node negative disease by palpation (p = 0.016). There was no statistically significant difference in breast conservation rates between group A and B (25.4% vs. 36.7%, p = 0.1). Addition of taxanes to anthracycline based regimens improved the pathological complete response in our patients with breast cancer.