Experience with neoadjuvant chemotherapy in patients with breast cancer.
OBJECTIVE
To determine the response rates to neoadjuvant chemotherapy in patients with breast cancer.


METHODS
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.


RESULTS
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).


CONCLUSIONS
Addition of taxanes to anthracycline based regimens improved the pathological complete response in our patients with breast cancer.
Zahid
Khawaja Farhan
KF
Medical Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre.
Siddique
Muhammad Kamran
MK
Siddiqui
Neelam
N
Muzaffar
Narjis
N
Asim
Muhammad
M
Azfar
Muhammad
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D016896:Treatment Outcome